Steyn Maryna, Buskes Jenifer
School of Anatomical Sciences, University of the Witwatersrand, Parktown, 2193, South Africa.
Department of Anatomy, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa.
Clin Anat. 2016 Oct;29(7):854-61. doi: 10.1002/ca.22688. Epub 2016 Apr 19.
Paleopathologists study the presence of diseases in the past and as such have a vast knowledge of skeletal changes associated with different conditions. Tuberculosis is one of the most studied diseases and still remains a major health problem today. Its manifestations in past populations have been extensively described, but less is known about its bony involvement in the post-antibiotic era. The aim of this study was to assess the frequency and manifestations of skeletal lesions in the post-antibiotic era in a South African sample and compare it to that found before the introduction of antibiotics. Skeletons of 205 individuals from modern skeletal collections and who are known to have died from TB were assessed. It was found that 39.2% of all individuals dying in the post-antibiotic era showed skeletal changes that could be associated with TB, while another 27.5% showed nonspecific changes. The highest incidences were found in individuals who died after 1985, when co-infection with HIV and drug resistance became common. While, as expected, vertebral and rib changes were the most common, the number of individuals who showed changes to the skull, and specifically intracranially, was surprising. These could most probably be associated with TB meningitis, although this specific cause of death was noted in only a few individuals. It seems that individuals may be living longer as a result of long-term antibiotic use, leaving more time for lesions to develop. Clin. Anat. 29:854-861, 2016. © 2016 Wiley Periodicals, Inc.
古病理学家研究过去疾病的存在情况，因此对与不同病症相关的骨骼变化有着广泛的了解。结核病是研究最多的疾病之一，至今仍是一个主要的健康问题。其在过去人群中的表现已被广泛描述，但在抗生素时代之后，人们对其骨骼受累情况了解较少。本研究的目的是评估南非样本在抗生素时代之后骨骼病变的频率和表现，并将其与抗生素引入之前的情况进行比较。对来自现代骨骼收藏且已知死于结核病的205人的骨骼进行了评估。结果发现，在抗生素时代之后死亡的所有个体中，39.2%表现出与结核病相关的骨骼变化，另有27.5%表现出非特异性变化。发病率最高的是1985年之后死亡的个体，当时与艾滋病毒的共同感染和耐药性变得普遍。正如预期的那样，脊柱和肋骨变化最为常见，但颅骨出现变化，特别是颅内变化的个体数量令人惊讶。这些变化很可能与结核性脑膜炎有关，尽管只有少数个体记录了这种具体死因。似乎由于长期使用抗生素，个体寿命可能延长，从而为病变发展留出了更多时间。《临床解剖学》2016年第29卷：854 - 861页。© 2016威利期刊公司。
