膝关节骨关节炎患者关节软骨中纳米细菌的检测  

Investigation of nanobacteria in the cartilage of patients with knee osteoarthritis

作　　者：彭伟秋 张祥洪 韦钊岚 丘立标 张湘生 刘傥 PENG Wei-qiu;ZHANG Xianghong;WEI Zhao-lan;QIU Li-biao;ZHANG Xiang-sheng;LIU Tang(Department of Orthopaedics,Liuzhou People’s Hospital,Guangxi University of Science and Technology,Liuzhou,Guangxi,545006,China)

机构地区：[1]广西科技大学附属柳州市人民医院关节骨病科,柳州545006 [2]中南大学湘雅医学院第二医院骨科,长沙410011

出　　处：《中国骨与关节杂志》2020年第2期99-103,共5页Chinese Journal of Bone and Joint

基　　金：广西壮族自治区卫生厅自筹项目(Z2008406).

摘　　要：目的通过人膝关节骨关节炎患者关节软骨中纳米细菌的培养检测,探讨纳米细菌与膝关节骨关节炎的关系。方法分别收集30例膝关节骨关节炎患者的关节软骨和30例正常膝关节的软骨进行纳米细菌的培养;每2周检测培养液中电解质K、Na、Cl、Ca、Mg和P的浓度;培养6周后免疫荧光鉴定和电镜检测。结果培养0周和6周时,膝关节骨关节炎组培养液中的K分别为(5.13±0.05、5.14±0.02) mmol/L、Na (155.60±1.18、155.46±0.84) mmol/L、Cl (125.70±1.25、125.82±0.90) mmol/L和Mg (0.93±0.06、0.93±0.04) mmol/L,无明显变化(P=0.52),但Ca为(2.54±0.06、2.55±0.02) mmol/L和P为(2.35±0.04、0.42±0.04) mmol/L,逐渐降低,差异有统计学意义(P=0.02)。培养0周和6周时,正常膝关节组培养液中的K分别为(5.14±0.04、5.15±0.04) mmol/L、Na (155.60±1.18、155.86±0.99) mmol/L、Cl (125.70±1.25、125.82±0.90) mmol/L、Ca (2.53±0.06、2.55±0.02) mmol/L、Mg (0.94±0.07、0.94±0.05) mmol/L,P (2.35±0.04、2.37±0.04) mmol/L,无明显的变化(P=0.51)。膝关节骨关节炎组30例培养液中免疫荧光检测全部检测到纳米细菌,阳性率100%;正常膝关节组30例中有1例检测出纳米细菌,阳性率3.33%。两组纳米细菌阳性率比较差异有统计学意义(χ^2=56.129,P=0.043)。透视电镜测量纳米细菌直径为80~400 nm。结论人膝关节骨关节炎患者关节软骨中纳米细菌阳性检测率100%,正常膝关节关节软骨中纳米细菌阳性检测率3.33%,二者差异显著,证实纳米细菌与膝关节骨关节炎的关系密切。纳米细菌是不是骨关节炎的病因之一,尚须进一步加以证实。Objective To investigate nanobacteria in the cartilage of patients with knee osteoarthritis by culturing and indentification. Methods Cartilages harvested from 30 osteoarthritis knees and 30 healthy knees were cultured to detect nanobacteria. Changes of electrolytes( K, Na, Cl, Ca, Mg, P) were dynamically recorded every 2 weeks. Immunofluorescence and electron microscope were used to observe results 6 weeks later. Results After culturing 0 and 6 weeks, concentrations of K in the OA cartilage were( 5.13 ± 0.05, 5.14 ± 0.02) mmol/L, Na( 155.60 ± 1.18, 155.46 ± 0.84) mmol/L, Cl( 125.70 ± 1.25, 125.82 ± 0.90) mmol/L, Mg( 0.93 ± 0.06, 0.93 ± 0.04) mmol/L with no significant differences( P = 0.52), while Ca( 2.54 ± 0.06, 2.55 ± 0.02) mmol/L and P( 2.35 ± 0.04, 0.42 ± 0.04) mmol/L decreased gradually in OA cartilage( P = 0.02);concentrations of K in the healthy cartilage were( 5.14 ± 0.04, 5.15 ± 0.04) mmol/L, Na( 155.60 ± 1.18, 155.86 ± 0.99) mmol/L, Cl( 125.70 ± 1.25, 125.82 ± 0.90) mmol/L, Ca( 2.53 ± 0.06, 2.55 ± 0.02) mmol/L, Mg( 0.94 ± 0.07, 0.94 ± 0.05) mmol/L, P( 2.35 ± 0.04, 2.37 ± 0.04) mmol/L with no significant differences( P = 0.51). In immunofluorescence investigations, nanobacteria which could emit green fluorescence were detected in all 30 osteoarthritis cartilages( 100%), and only 1 in healthy cartilage( 3.33%). Differences in positive rate between the 2 groups were statistically significant( χ^2 = 56.129, P = 0.043). The size of nanobacteria was 80-400 nm by electron microscope analysis. Conclusions Nanobacteria are correlated with knee osteoarthritis. Further study is needed to confirm its role in the biological etiopathogenesis of osteoarthritis.

关 键 词：骨关节炎 软骨 关节 膝关节 纳米医学 细菌 显微镜检查 电子 扫描透射 

分 类 号：R684.3[医药卫生—骨科学] R446.5[医药卫生—外科学]