摘要
目的通过巢式聚合酶链式反应(polymerase chain reaction,PCR)动态检测脊柱结核患者围手术期外周血的MTB-DNA的IS6110基因的含量,评估术前短期化疗对脊柱结核患者的手术安全性。方法根据IS6110基因设计两对特异性硫化修饰引物,结合高效保真聚合酶建立的巢式PCR,动态检测25例术前短期化疗的脊柱结核患者术前1天、术后1天、术后7天、术后14天外周血MTB-DNA的IS6110基因的含量变化,对外周血扩增产物IS6110基因含量进行比较分析。结果脊柱结核患者围手术期外周血IS6110基因含量变化的两种趋势:(1)15例患者伴随术后结核病灶的清除,外周血中的结核杆菌IS6110基因的从术后1天就开始逐渐减少;(2)10例患者术后1天时外周血中结核杆菌IS6110基因有短暂回升,但与术前1天外周血中结核杆菌IS6110基因含量比较无显著性差异(P>0.05),随着术后持续抗痨治疗,结核杆菌IS6110基因含量在术后1～2周均减少,均未发生结核杆菌血行播散并发症。结论如果脊柱结核患者一般情况好,术前短期化痨后行手术治疗安全有效。
Objection To detect the changes of MTB - DNA contents in IS6110 gene in peripheral blood through dynamic monitoring by nested PCR technique in order to evaluate the safety of preoperative short - term chemotherapy for spinal tuberculosis before spinal surgery.Methods According to nested PCR technique,two pairs of specifical sulfidemodified primers were established.The changes in the IS6110 gene of MTB - DNA contents in the peripheral blood were dynamically monitored in 25 spinal tuberculosis patients.Results IS6110 level in 15 peripheral blood samples decreased gradually 1 day after surgery,followed by obviously decreased at 1 to 2 weeks.On the other hand,one day after surgery, tuberculosis IS6110 gene in 12 peripheral blood samples briefly increased,followed by obviously decreased at 7 and 14 days.But it was not significantly different,compared with IS6110 gene content in peripheral blood of 1 day before surgery （P0.05）.As the postoperative continuous anti -tuberculosis treatment,IS6110 gene of mycobacterium tuberculosis contents reduced after 1 - 2 weeks,and no complications of tuberculosis hematogenous occurred.Conclusion If the general health condition of patients with spinal tuberculosis is good,the surgery for spinal tuberculosis is safe after preoperative short - term chemotherapy.
出处
《中国骨与关节外科》
2010年第6期470-475,共6页
Chinese Journal of Bone and Joint Surgery
关键词
脊柱结核
术前化疗
巢式PCR
手术
Spinal tuberculosis
Preoperative chemotherapy
Nested PCR
Surgery
