| 169 | 4 | 31 |
| 下载次数 | 被引频次 | 阅读次数 |
目的建立H37Rv结核分支杆菌诱导的兔脊柱结核模型。方法选择未致敏处理的新西兰大白兔48只,在第5腰椎近椎间盘处钻孔,并填充明胶海绵,注射0.5 mg/0.1 m L结核菌悬液,术后观察新西兰大白兔一般情况,并用影像学、组织病理学、细菌学等检查对兔脊柱结核模型进行评估。结果受H37Rv结核菌株感染后的新西兰大白兔,局部反应较明显,全身反应较轻。48只兔中38只兔完成实验,10只因死亡、术后截瘫被淘汰,15只兔分别于术后第5、6周出现进食欠佳、消瘦,但生命体征平稳,其中4只术区局部肿胀,6只出现下肢运动障碍;其余23只兔术后进食较好,体质量未见明显变化。术后3个月行外科手术,暴露致病兔椎体,38只兔中29只兔椎体可见虫噬样改变,9只兔椎体未见明显变化。术中取脓肿形成的兔脓液培养示结核分枝杆菌生长;取周围软组织、脓壁行苏木精-伊红色(HE)染色,示坏死灶形成、较多炎细胞聚集、淋巴细胞、较少上皮样细胞,骨结构紊乱或消失。建立模型成功率为76.3%(29/38)。结论使用0.5 mg/0.1 m L的H37Rv标准菌株感染的新西兰白兔结核模型建立成功。
Abstract:Objective To build a spinal tuberculosis model by drilling and planting mycobacterium tuberculosis H37 Rv standard strains in the lumbar vertebra of New Zealand white rabbits to provide animal models for future fundamental researches on bone tuberculosis. Methods Drill bone holes on the top of the 5th lumbar vertebra near the intervertebral disk of 48 non-sensitized New Zealand white rabbits and fill in gelatin sponge to absorb TB suspension( bacteria amount: 0. 5 mg /0. 1 m L) for modeling,and set the vacant group. After the operation,inspect and confirm the models by general observation,images,histopathology,bacteriology and other means. Results There were significant local reactions in H37 Rv tuberculosis-infected New Zealand rabbits,but with a slightly systematic response. 38 rabbits finished the trial(38 /48) and 10 rabbits were eliminated due to deaths and postoperative paraplegia. And 15 rabbits had the signs of poor diet,marasmus and stable vitality(15 /38) at week 5 and 6respectively after operation,4 of which(4 /15) had local swelling in the operation area and 6 of lower limb dyskinesia(6 /15),and the rest 23 rabbits were stable and had good diet,with unchanged quality(23 /38). The surgery was conducted 3 months after to explore the pathogenic vertebrae of rabbits,and insect-bite changes were found in 29 rabbits(29 /38). There were not any significant changes in the vertebrae of 9 rabbits. The vertebrae were exposed 3 months after operation,29 of which were ill,with insect-bite changes in the exposed vertebrae at different levels. The pus culture from the abscess taken from the operation showed the growth of mycobacterium tuberculosis. The peripheral soft tissues and pus walls were taken for HE staining,which showed the formation of necrosis,more infected cells aggregation,less lymphocytes,and the epithelioid cells and bone structure were disordered and disappeared. The success rate of modeling is 76. 3%(29 /38). Conclusion It proved successful to set up tuberculosis models for New Zealand white rabbits with 0. 5mg /0. 1m L of H37Rv-infected standard strains.
[1]Tuli SM.General principles of osteoarticular tuberculosis[J].Clin Orthop Relat R,2002(98):11-19.
[2]Almeida A.Tuberculosis of the spine and spinal cord[J].Eur J Radiol,2005,55(2):193-201.
[3]Golden MP,Vikram HR.Extrapulmonary tuberculosis:an overview[J].Aust Fam Physician,2005,72(3):1761-1768.
[4]刘正文,呼西旦,付明花,等.兔脊柱结核模型的构建[J].中华实验外科杂志,2012,29(4):758-761.
[5]王非,瞿东滨,金大地.侧方入路显露兔腰椎间盘及椎间盘内的注射方法[J].中华实验外科杂志,2003,20(3):204.
[6]Kalita J,Misra UK,Mandal SK,et al.Prognosis of conservatively treated patients with Pott’sparaplegia:logistic regression analysis[J].J Neurol Neurosur Ps,2005,76(8):866-868.
[7]李冬,李卓荣.抗结核药物的研究进展[J].中国新药杂志,2009,8(1):35-42.
[8]中国防痨协会.结核病诊断细菌学检验规程[J].中国防痨杂志,1996,18(2):28-31.
[9]吴龙章,蔡杏珊,潘美玉,等.Bac T/ALERT 3D全自动培养仪在细菌鉴定和药敏试验的临床应用[J].中华检验医学杂志,2002,25(4):243-244.
[10]林旭.缓释利福平微球释药性质及兔脊柱结核模型建立的初步实验研究[D].四川大学,2006.
[11]张泽华,罗飞,吴铮,等.基因芯片早期诊断脊柱结核耐药[J].中华检验医学杂志,2010,33(11):1090-1093.
[12]陈孝平,石应康,邱贵兴,等.外科学[M].北京:人民卫生出版社,2006:325-326.
[13]Mak KC,Cheung KMC.Surgical treatment of acute TB spondylitis:indications and outcomes[J].Eur Spine J,2013,22(4Suppl):603-611.
[14]施学东,李淳德,米川,等.单纯前路手术治疗脊柱结核[J].北京大学学报:医学版,2011,(5):777-780.
[15]Jain AK,Jain S.Instrumented stabilization in spinal tuberculosis[J].Int Orthop,2012,36(2):285-292.
[16]王自立.恰当选择脊柱结核手术入路[J].中国脊柱脊髓杂志,2012,22(9):769-770.
[17]许建中.脊柱结核的治疗方案存在仁智之争[J].中华骨科杂志,2011,31(4):394-399.
[18]瞿东滨,金大地.正确认识脊柱结核病灶清除术[J].中国脊柱脊髓杂志,2008,18(8):565-567.
[19]王自立.脊柱结核的病灶清除与融合固定问题[J].中国脊柱脊髓杂志,2006,16(12):876-878.
[20]林羽.浅谈脊柱结核的手术治疗[J].中国脊柱脊髓杂志,2006,16(12):885-887.
[21]戈朝晖,王自立,魏敏吉.脊柱结核病灶中抗痨药物浓度的测定[J].中华骨科杂志,2005,25:97-101.
[22]梁求真,折胜利,宋兴华,等.体外构建抗结核性骨组织工程复合体的实验研究[J].中国矫形外科杂志,2014,22(19):1789-1796.
[23]梁求真,吐汉·艾买提,宋兴华,等.利福平对兔脂肪干细胞增殖、成骨及黏附支架的影响[J].医学研究杂志,2014,43(2):27-31.
[24]折胜利,罗兰,吕顺忠,等.利福喷丁的溶解性与稳定性考察[J].中国药房,2012,(17):1556-1558.
基本信息:
中图分类号:R529.2;R-332
引用信息:
[1]陶亢,张峥,呼西旦·阿巴拜克力,等.兔脊柱结核模型建立的实验研究[J].新疆医科大学学报,2015,38(08):937-940.
基金信息:
国家自然科学基金(81360283)
2015-06-08
2015
2015-09-22
2015
2015-06-13
1
2015-08-15
2015-08-15