骨矿物质成分的改变作为糖尿病足骨髓炎的早期指征。
Alterations to bone mineral composition as an early indication of osteomyelitis in the diabetic foot.
作者信息
Esmonde-White Karen A, Esmonde-White Francis W L, Holmes Crystal M, Morris Michael D, Roessler Blake J
机构信息
Corresponding author: Blake J. Roessler,
出版信息
Diabetes Care. 2013 Nov;36(11):3652-4. doi: 10.2337/dc13-0510. Epub 2013 Aug 6.
Abstract
OBJECTIVE
Osteomyelitis in the diabetic foot is a major risk factor for amputation, but there is a limited understanding of early-stage infection, impeding limb-preserving diagnoses. We hypothesized that bone composition measurements provide insight into the early pathophysiology of diabetic osteomyelitis.
RESEARCH DESIGN AND METHODS
Compositional analysis by Raman spectroscopy was performed on bone specimens from patients with a clinical diagnosis of osteomyelitis in the foot requiring surgical intervention as either a biopsy (n = 6) or an amputation (n = 11).
RESULTS
An unexpected result was the discovery of pathological calcium phosphate minerals in addition to normal bone mineral. Dicalcium phosphate dihydrate, also called brushite, and uncarbonated apatite were found to be exclusively associated with infected bone.
CONCLUSIONS
Compositional measurements provided a unique insight into the pathophysiology of osteomyelitis in diabetic foot ulcers. At-patient identification of pathological minerals by Raman spectroscopy may serve as an early-stage diagnostic approach.
摘要
目的
糖尿病足骨髓炎是截肢的主要危险因素，但对早期感染的了解有限，这阻碍了保肢诊断。我们假设骨成分测量有助于深入了解糖尿病骨髓炎的早期病理生理学。
研究设计与方法
对临床诊断为足部骨髓炎且需要手术干预（活检，n = 6；截肢，n = 11）的患者的骨标本进行拉曼光谱成分分析。
结果
一个意外的结果是，除了正常骨矿物质外，还发现了病理性磷酸钙矿物质。二水磷酸二钙，也称为透钙磷石，以及无碳酸磷灰石被发现仅与感染骨相关。
结论
成分测量为糖尿病足溃疡骨髓炎的病理生理学提供了独特的见解。通过拉曼光谱在患者身上识别病理性矿物质可作为一种早期诊断方法。
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