骨与关节活检标本中结核诊断方法的研究进展  

Research progress in diagnosis method of tuberculosis in bone and joint biopsy specimens

作　　者：陈春宇 陈乙楠 何纲[3] 甄沛林[4] CHEN Chun-yu;CHEN Yi-nan;HE Gang;ZHEN Pei-lin(Infectious Diseases Studies,Guangdong Medical University,Zhanjiang Guangdong Province 524000,China;Department of Stomatology,Guangdong Jiangmen Central Hospital;Department of Infection,Guangdong Jiangmen Central Hospital;Department of Science and Education,Guangdong Jiangmen Central Hospital)

机构地区：[1]广东医科大学,广东湛江524000 [2]广东省江门市中心医院口腔科 [3]广东省江门市中心医院感染科 [4]广东省江门市中心医院科教科

出　　处：《中国城乡企业卫生》2024年第3期36-40,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：结核病仍然是世界范围内与传染性疾病相关的最常见死亡原因之一,其中骨与关节结核病在肺外结核中占比为10%~15%。骨与关节结核病早期的发病隐匿,临床和放射学无明显的特异性表现以及病灶组织中含菌量少,对骨与关节结核的诊断提出了较大的挑战,误诊以及延迟诊断可能会导致骨、关节不同程度的损伤,严重影响患者生活质量及生命安全,因此早期的骨关节结核诊断尤为重要。骨结核的诊断主要依赖于组织学检查,通常在影像学图像的引导下或关节镜下进行穿刺活检,也可以在开放性手术中取得骨组织标本(包括骨组织、关节腔脓液、关节腔滑膜液)。通常取得组织活检标本后进行抗酸染色、细菌培养,但其灵敏度低、耗费时间长。随着分子生物学技术的发展,出现了一批可以快速利用骨组织活检标本诊断结核的新技术。本文对骨与关节的活检标本的各种结核诊断技术研究进展进行综述,以期为临床骨与关节结核病的诊断提供参考。Tuberculosis is still one of the most common causes of death related to infectious diseases worldwide,in which bone and joint tuberculosis accounts for 10%-15%of extrapulmonary tuberculosis.The early onset of bone and joint tuberculosis is hidden,the clinical and radiological manifestations are not significantly specific,and the amount of bacteria in the focus tissue is little,pose great challenges in the diagnosis of bone and joint tuberculosis.Misdiagnosis and delayed diagnosis may lead to different degrees of bone and joint damage,which seriously affects the quality of life and safety of patients.Therefore,early diagnosis of bone and joint tuberculosis is particularly important.The diagnosis of bone tuberculosis mainly depends on histological examination.Usually,puncture biopsy is conducted under the guidance of imaging images or arthroscopy,or bone tissue samples(including bone tissue,joint cavity pus,joint cavity synovial fluid)can be obtained in open surgery.Usually,the tissue biopsy specimens are stained with acid fast stain and bacterial culture,but the sensitivity is low and the time consuming is long.With the development of molecular biology technology,a number of new technologies have emerged that can rapidly use bone biopsy specimens to diagnose tuberculosis.This article reviews the research progress of various tuberculosis diagnostic techniques of bone and joint biopsy specimens,in order to provide reference for clinical diagnosis of bone and joint tuberculosis.

关 键 词：骨与关节结核 分子生物学 聚合酶链反应 研究进展 活检标本 

分 类 号：R529.2[医药卫生—内科学]