布鲁氏菌脊柱炎临床特点分析

Analysis of clinical characteristics of Brucella spondylitis

目的探讨布鲁氏菌脊柱炎患者的临床特点。方法回顾性分析32例布鲁氏菌脊柱炎患者的临床资料,采用虎红平板凝集法进行布鲁氏菌抗体检测,患者均采用多西环素、利福平、头孢噻肟钠治疗。统计分析患者治疗后的临床表现、影像学表现及布鲁氏菌抗体滴度。结果治疗后,患者逐渐恢复体力,无多汗,无发热,无神经痛,活动自如,无肢体麻木及疼痛。治疗后,影像学显示患者脓肿逐渐吸收,骨质破坏逐渐恢复,炎症过程和骨与组织的纤维化逐渐好转。患者经规范治疗后抗体滴度逐渐下降至1∶100(++)以下或阴转。结论布鲁氏菌脊柱炎多侵犯椎体,造成骨质破坏,伴有骨质增生,可形成小脓肿,患者活动受限,易被误诊为脊柱结核和脊柱肿瘤,经早期、联合、足量、足疗程规范治疗,患者预后良好。

Objective To discuss the clinical characteristics of Brucella spondylitis.Methods The clinical data of 32 patients with Brucella spondylitis were retrospectively analyzed.Rose bengal plate agglutination test was used for the detection of Brucella antibodies,and the patients were treated with doxycycline,rifampicin,and cefotaxime sodium.The clinical manifestations,imaging manifestations and Brucella antibody titers after treatment were statistically analyzed.Results After treatment,the patient gradually recovered physical strength,no hyperhidrosis,no fever,no neuralgia,free movement,no limb numbness and pain.After treatment,imaging studies showed that the patient’s abscess was gradually absorbed,bone destruction gradually recovered,and the inflammation process and bone and tissue fibrosis gradually improved.After standard treatment,the patient’s antibody titer gradually dropped below 1∶100(++)or turned negative.Conclusion Brucella spondylitis often invades vertebral body,causes bone destruction,accompanied by bone hyperplasia,and can form small abscess.Patients with limited activity are easy to be misdiagnosed as spinal tuberculosis and spinal tumors.After early,combined,sufficient and full-scale treatment,the prognosis of patients is good.