摘要
脊柱感染性疾病是由特定病原菌引发脊柱不同部位疾病,分类包括化脓性、肉芽肿性、寄生虫性感染等,且不同病原体有特定感染方式与表现。临床表现有背痛、发热等,免疫抑制患者症状可不典型。影像学检查中,X线逐渐被CT、MRI等取代,CT对骨质结构评估有优势,MRI对软组织及炎症显示良好,不同类型脊柱感染在CT、MRI上各具特征。实验室检查包括血液培养、血清学检测等,生物标志物有助于诊断与疗效评估。微生物学在诊断中面临致病菌多样性与耐药性问题,微生物培养是确诊金标准但有局限,分子生物学技术可快速鉴定菌种与监测耐药性,宏基因组二代测序技术能检测所有微生物遗传物质,虽有优势但受成本与操作流程限制,结合人工智能技术有望提升其准确性与实用性,综合多方面因素制定个性化治疗方案对提高治愈率、降低致残率至关重要。本文全面阐述了脊柱感染性疾病的诊治进展。
Infectious diseases of the spine are diseases that occur in different parts of the spine and are caused by specific pathogenic bacteria.They are classified into purulent,granulomatous,parasitic infections,etc.,and different pathogens have specific infection patterns and manifestations.The clinical manifestations include back pain,fever,etc.,and the symptoms in immunocompromised patients may be atypical.In imaging examinations,X-ray is gradually being replaced by CT,MRI,etc.CT has an advantage in evaluating bone structures,while MRI shows good performance in displaying soft tissues and inflammations.Different types of spinal infections have their own characteristics on CT and MRI images.Laboratory examinations include blood culture,serological tests,etc.,and biomarkers are helpful for diagnosis and the evaluation of treatment effects.Microbiology faces the problems of the diversity of pathogenic bacteria and drug resistance in diagnosis.Microbial culture is the gold standard for diagnosis,but it has limitations.Molecular biology techniques can quickly identify bacterial species and monitor drug resistance.Metagenomic next-generation sequencing technology can detect all microbial genetic materials.Although it has advantages,it is limited by costs and operation procedures.Combining with artificial intelligence technology is expected to improve its accuracy and practicability.Formulating personalized treatment plans by integrating multiple factors is crucial for improving the cure rate and reducing the disability rate.This article comprehensively expounds on the progress in the diagnosis and treatment of infectious diseases of the spine.
作者
王飞
张双明
胡建锋
李金锁
厉孟
WANG Fei;ZHANG Shuangming;HU Jianfeng;LI Jinsuo;LI Meng(Department of Orthopedics,Tianshui Hospital of Traditional Chinese Medicine,Tianshui 741000,Gansu,China;Department of Orthopaedics,Gansu Provincial People's Hospital)
出处
《中国病原生物学杂志》
北大核心
2025年第5期670-673,682,共5页
Journal of Pathogen Biology
关键词
脊柱感染性疾病
诊断
磁共振成像
宏基因组二代测序技术
综述
spinal infectious diseases
diagnosis
magnetic resonance imaging
metagenomic next-generation sequencingtechnology
review
作者简介
通信作者:厉孟,E-mail:lilionli@126.com;王飞(1977-),男,甘肃靖远人,大学本科,副主任医师,研究方向:脊柱,四肢创伤,关节运动损伤。E-mail:wangfei2916@126.com。
