摘要
目的:探讨布鲁氏菌性脊柱炎的诊断方法和药物治疗效果。方法:2006年2月至2006年12月收治6例布鲁氏菌性脊柱炎患者,回顾性分析其临床表现、体征、影像学特点及实验室检查情况,均采用利福平和多烯环素联合药物治疗。结果:6例患者临床表现均为定时高热,腰背疼痛剧烈,大汗和乏力;局部深在叩压痛,无明确的神经受损体征。影像学显示椎间隙感染和邻近椎体骨髓炎征象。实验室检查血沉和C反应蛋白增高,血清布鲁氏菌凝集试验阳性,血培养有3例显示布鲁氏杆菌阳性。通过联合药物治疗2周后,6例患者发热大汗症状消失,其中4例腰背疼痛症状消失,2例患者腰背疼痛症状明显减轻;5例治疗3个月后,腰背疼痛症状消失,血沉和C反应蛋白降至正常,连续3次血培养阴性;1例未足程治疗者出现复发,继续治疗3个月后症状消失。均未出现并发症。结论:布鲁氏菌性脊柱炎可以通过典型的临床表现、影像特点及特殊的实验室检查明确诊断,采用利福平和多烯环素联合治疗可以取得满意的效果。
Objective:To discuss the diagnosis and medicine treatment of brucellar spondylitis.Method:A total of 6 cases with brucellar spondylitis undergoing the treatment of the combination of rifampin and doxycycline for at least 3 months from Feb 2006 to Dec 2006 were reviewed retrospectively,their clinical presentation, physical symptom,radiological features as well as laboratory findings were reviewed during the course.Result: High fever,severe low back pain and weak,local deep palpation without any neurological deficit were noted in all cases,intervertebralitis and adjacent segment spondylitis were evidenced radiographically,ESR and CRP value increased with brucellar agglutination titer of less than l:160,blood culture results showed positive brucellosis in 3 cases.After 2 weeks of medicine,sweating disappeared in 6 cases,of these,low back pain disappeared in 4 cases and relieved partially in 2 cases.After medicine treatment for 3 months,low back pain disappeared in 5 cases with ESR and CRP lowed in normal,and 3 continuous blood culture showed negative result.One patient not accepting enough course of medicine had recurrence of primary disease,which was cured after 3 months of adequate medicine.Conclusion:Brucellar spondylitis has characterized clinical manefes- tations,radiographic features and special laboratory findings,which can be treated successfully by combination of rifampin and doxycycline.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第6期437-439,共3页
Chinese Journal of Spine and Spinal Cord
关键词
布鲁氏杆菌
脊柱炎
诊断
治疗
Brucellosis
Spondylitis
Diagnosis
Treatment