结核菌L型与骨关节结核复发及恶化的研究

A study of the association between tubercule bacillus L form and the re - treated cases of osteoarticular tuberculosis

目的 探讨骨关节结核病灶中,是否有结核菌L型的存在。方法 对60例骨关节结核病人病灶内的脓液、肉芽、干酪物等,经碱液处理后,分别进行直接涂片,并接种在罗氏培养基上、Bactec培养液及结核菌L型培养液中,以查找结核杆菌及结核菌L型。结果 60例病人中,查到结核菌L型11例,对于结核菌检出的阳性率经统计学处理,涂片的阳性率(15％)与罗氏培养的阳性率(5％)均较低,快速培养为20％,罗氏培养与快速培养间差异有显著意义(x2=6.17,P<0.05)。结论 对于临床治疗不满意或复治病例,在作结核菌培养的同时,加做结核菌L型检查是极为必要的。

Objective To explore the presence of tubercle bacillus L form in the focus of bone and joint tuberculosis in cases undergone revision procedures. Methods The sample of pus, caseous material were procured from 60 patients with pathological confirmed diagnosis of tuberculosis. After alkali treatment of the sample, Z-N smear, inoculation in Rhodes Bactce, and culture in L from tubercle bacillus culture solution were carried out for searching tubercle bacilli and tubercle bacillus L form. Results In 11 cases the existence of tubercle bacillus L form was found in the focus; the positive rate of the tubercle bacillus was low both the smear (15%) and Rhodes culture medium (5%) . In rapid culture the positive rate was 20% . There is difference in evidence between Rhodes culture and expeditiousness culture, (x2= 6.17) (P < 0.05.)Conclusion It is necessary to have L form tubercle bacillus examination using the same sample with the bacteria culture for the unsatisfactory and re-treated patients.