人工关节假体不同材料及材料表面粗糙度对表皮葡萄球菌粘附能力的影响  

Bacterial adherence to the commonly used joint implants material surface in vitro

作　　者：郝立波[1] 邢庆昌[1] 王继芳[1] 王岩[1] 张小斌[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中华关节外科杂志（电子版）》2008年第5期34-36,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨人工关节假体材料及表面粗糙度对表皮葡萄球菌粘附能力的影响。方法制作超高分子聚乙烯、钛合金和钴铬钼合金试样,表皮葡萄球菌经FITC标记,人工关节材料试样消毒后接种FITC标记的表皮葡萄球菌,试样表面分为光滑表面和粗糙表面,每组各6个试样,将含有细菌和试样的24孔板在37℃下孵育30min后,用荧光显微镜观察,试样用扫描电镜观察。结果对于光滑的人工关节常用材料表面,表皮葡萄球菌对超高分子聚乙烯(UHMWPE)的粘附能力显著高于钛合金和钴铬钼合金(P<0.001),对钴铬钼合金的粘附能力要高于钛合金(P<0.05);粗糙的超高分子聚乙烯和钴铬钼合金表面比光滑的表面更易引起表皮葡萄球菌的粘附(P<0.01),而细菌对粗糙钛合金的粘附仅轻微高于光滑钛合金(P>0.05)。荧光照相观察及扫描电镜观察显示细菌在粗糙表面的划痕内聚集粘附。结论本研究结果表明细菌对人工关节材料表面的粘附能力不但取决于细菌本身,也和材料性质和表面粗糙度有关。Objective Evaluation of bacterial adhesion to material of total joint prothesis. Methods A bacterial adhesion assay was performed by culturing Staphylococcus epidermidis （clinical isolate） for one hour with PMMA, cobalt-chromium alloy, titanium alloy, grit-blasted and polished implant discs. Adhered bacteria were stained using fluorescence assay. Adherence was then quantitatively evaluated by fluorescence microscopy and digital image processing. Qualitative adherence of the bacteria was analyzed with a scanning electron microscope. Results Bacterial adherence of S. epidermidis varied significantly with the type of implant, polished PMMA presented with significantly （ P 〈 0. 001 ） higher S. epidermidis adhesion compared to polished cobah-chromium alloy and titanium alloy. Furthermore there was a statistically significant correlation between bacterial adherence and surface roughness of the tested implants. Conclusions The adhesion of S. epidermidis is effected by the implant material and surface roughness.

关 键 词：人工关节 感染 葡萄球菌 表皮 细菌粘附 

分 类 号：R687.4[医药卫生—骨科学] R318.08[医药卫生—外科学]