结核杆菌在不同内固定材料表面粘附情况的实验研究

目的:通过体外实验动态地观察结核杆菌与不同内固定材料的粘附情况,以期初步探讨在脊柱结核病灶清除后直接植入内固定重建的安全性问题,为临床选择合理的重建手术术式提供直接的理论和实验依据,并指导临床上对内固定材料的选择。方法:以表皮葡萄球菌为对照,在结核杆菌、表皮葡萄球菌的菌液中分别加入4种不同的内固定材料(不锈钢、钛、钛合金、聚醚醚酮)进行培养,通过扫描电镜观察细菌与材料之间的粘附情况,比较不同性质材料对细菌粘附的差别。结果:结核杆菌、表皮葡萄球菌与材料的粘附能力与生长曲线基本一致;结核杆菌与材料间的粘附均少于表皮葡萄球菌;4种材料中细菌在聚醚醚酮上的粘附最多,在纯钛上粘附最少,在不锈钢上的粘附稍多于钛合金,且各种材料间差异有统计学意义(P<0.05)。结论:从体外细菌粘附的角度看,在结核病灶内植入内固定材料是相对安全的;内固定材料,以钛合金及钛为首选,碳纤维材质慎用。

Study on adhesive properties of tuberculosis onto the surface of different implant material

Objective:The adhesion of tuberculosis onto the surface of different implant material in vitro was studied in order to evaluate the risk of tuberculosis infection in spinal instrumentation surgery for spinal tuberculosis.Methods:Staphylococcus epidermidis was selected as control group.Different materials(stainless steel﹑titanium alloy﹑titanium﹑polyetheretherketone)were individually placed in different bacterial suspensions.The adherences of two types of bacteria onto the surfaces of different materials were investigated by scanning electron microscopy(SEM)respectively.Results:The capacities of two types of bacteria for adhesion to stainless steel﹑titanium alloy﹑titanium and PEEK coincided with the bacterial-growth curve.The adherence of Mycobacterium tuberculosis onto the surface of four materials was very fewer than that of Staphylococcus epidermidis.The amount of adhesive bacteria on PEEK were most,and the amount of adhesive bacteria on titanium were fewest.The amount of adhesive bacteria on stainless steel were more than on titanium alloy.Conclusion:From the point of bacterial adhesion,instrumentation surgery is safe to spinal tuberculosis infection;From the point of selection of implant materials,titanium alloy and titanium are the best,polyetheretherketone must be selected carefully.