脊柱结核分枝杆菌感染早期椎体骨小梁微结构及骨密度变化的研究OA北大核心CSTPCD
Changes in the microstructure and bone mineral density of vertebral tra-becular bone in the early stages of spinal Mycobacterium tuberculosis in-fection
目的 观察比较脊柱结核分枝杆菌感染早期椎体骨密度的变化.方法 连续收集2023年1月1日-12月31日就诊于中南大学湘雅医院脊柱外科的脊柱结核手术患者(脊柱结核组),依据性别匹配椎管狭窄就诊的非脊柱结核手术患者为对照组.对入组患者进行双能X线扫描,比较两组患者椎体骨密度的差异.构建脊柱结核分枝杆菌感染动物模型(简称动物模型),比较动物模型脊柱结核组与对照组的骨小梁微结构差异,选择骨组织/体积骨量(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁数量(Tb.N)和骨小梁分离度(Tb.Sp)作为评价指标,进一步分析病椎与邻椎的骨质差异.结果 脊柱结核组和对照组分别纳入69例患者,脊柱结核组患者骨密度[0.793(0.712,0.869)g/cm2]低于对照组[0.907(0.800,1.020)g/cm2],差异有统计学意义(P＜0.05).动物模型脊柱结核组小鼠的骨小梁微结构 BV/TV[(18.4±5.4)％]、Tb.Th[(0.124±0.010)mm]较对照组 BV/TV[(22.6±3.2)％]、Tb.Th[(0.160±0.017)mm]发生明显改变(均P＜0.05).动物模型脊柱结核组中,小鼠病椎骨小梁微结构BV/TV[(25.5±6.7)％]、Tb.N[(1.871±0.443)/mm]低于邻椎的 BV/TV[(26.6±6.8)％]、Tb.N[(1.969±0.454)/mm],差异均有统计学意义(均P＜0.05).结论 结核分枝杆菌感染椎体早期可引起骨小梁微结构发生改变,进而导致骨密度降低.
Objective To observe and compare the changes of vertebral bone mineral density(BMD)in the early stages of spinal Mycobacterium tuberculosis infection.Methods Patients who underwent spinal surgery at Xiangya Hospital,Central South University from January 1 to December 31,2023 were continuously enrolled(spinal tuber-culosis group),based on gender matching,non-spinal tuberculosis surgical patients treated for spinal stenosis were selected as the control group.Dual-energy X-ray scans were performed on the enrolled patients,difference in verte-bral BMD between two groups of patients was compared.An animal model of spinal Mycobacterium tuberculosis in-fection(referred to as the animal model)was constructed,differences in microstructure of trabecular bone between spinal tuberculosis group and control group was compared,and the bone volume/tissue volume(BV/TV),the thickness of trabecular bone(Tb.Th),the number of trabecular bone(Tb.N),and sparse density of trabecular(Tb.Sp)were used as evaluation indexes to further analyze the bone quality differences between the diseased verte-brae and the neighboring vertebrae.Results 69 patients were included in the spinal tuberculosis group and the con-trol group,respectively.The BMD of patients in the spinal tuberculosis group(0.793[0.712,0.869]g/cm2)was lower than that of the control group(0.907[0.800,1.020]g/cm2),difference was statistically significant(P＜0.05).Microstructure of trabecular bone BV/TV([18.4±5.4]％),Tb.Th([0.124±0.010]mm)in the spinal tuberculosis group of animal model were significantly altered compared with BV/TV([22.6±3.2]％),Tb.Th([0.160±0.017]mm)in the control group(both P＜0.05).In the spinal tuberculosis group,microstructure of diseased vetebral trabecular bone BV/TV([25.5±6.7]％)and Tb.N([1.871±0.443]/mm)were significantly lower than BV/TV([26.6±6.8]％)and Tb.N([1.969±0.454]/mm)in the neighboring vertebrae,both with statistically difference(both P＜0.05).Conclusion In the early stages of spinal Mycobacterium tuberculosis infec-tion,microstructure of vertebral trabecular bone can be altered,leading to a decrease in BMD.
陈俊宝;罗翼;熊南均;胡小江;郭超峰;高琪乐;李艳冰
中南大学湘雅医院脊柱外科,湖南长沙 410008||国家老年疾病临床医学研究中心(湘雅医院),湖南长沙 410008国家老年疾病临床医学研究中心(湘雅医院),湖南长沙 410008||中南大学湘雅医院检验科,湖南长沙 410008
临床医学
脊柱结核结核分枝杆菌骨密度骨小梁微结构
spinal tuberculosisMycobacterium tuberculosisbone mineral densitymicrostructure of trabecular bone
《中国感染控制杂志》 2024 (008)
1001-1006 / 6
国家自然科学基金项目(82072460、82170901);湖南省自然科学基金项目(2023JJ30878)
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