抗生素对人体椎间盘的渗透性研究

The permeabitity of antibiotics into the human intervertebral disc

目的探讨抗生素对人体椎间盘的渗透性，为椎间盘炎的抗生素治疗提供理论依据。方法３２例腰椎间盘突出的病人随机分成四组，分别给予先锋霉素Ⅴ氟氯西林，妥布霉素，克林霉素静脉滴注３０分钟，给药完毕后，用经皮椎间盘术（ＰＬＤ）技术取髓核，同时抽取静脉血送检，用高效液相色谱系统测定标本的抗生素浓度。结果克林霉素、妥布霉素、先锋霉素Ⅴ在髓核内可达到有效抑菌浓度，氟氯西林未达到有效抑菌浓度。结论克林霉素、妥布霉素、先锋霉素Ⅴ可用于治疗椎间盘炎。

Purpose To assess the antibiotic permeabitity into human intervertebral disc after intravenous adminstration in order to establish the theoretical basis of antibiotics treatment of discitis. Methods 32 cases with lumbar disc protrusion were classified into 4 groups randomly, 8 cases per group. Cephazolin,Flucloxacillin,Clindamycin and Tobramycin were administrated intravenously respectively. The nucleus pulposus specimens were obtained with PLD technique in 30 minutes interval after receiving 30 minute course of intravenous administration of antibiotics. The venous blood samples were obtained simultaneously. Antibiotic concentration in tissues were determined by high pressure liquid chromatography. Results Clindamycin, Tobramycin and Cephazolin achieved theraputic level in the nucleus pulposus. Conclusion Clindamycin, Tobramycin, Cephazolin given intravenously could be effective in treating discitis.