摘要
关节假体周围感染(PJI)是关节置换术后的严重并发症。药物治疗是目前PJI治疗的基础，但由于生物膜的屏障作用及耐药机制的存在，目前PJI的药物治疗效果仍不尽满意。近年来，噬菌体疗法受到越来越多人的关注，其在PJI治疗中的应用逐渐受到重视并涌现出一些新的研究思路和进展。噬菌体是自然存在的病毒，专门攻击和裂解细菌，对生物膜中的细菌也具有杀灭作用，且对细菌种类具有高度特异性而不影响人体微生物群。本文从生物膜的形成及耐药机制、噬菌体的生物类型及其杀菌机制、噬菌体对PJI的诊断作用、噬菌体治疗PJI的优势及限制以及噬菌体治疗PJI的临床进展等方面对噬菌体用于PJI治疗的研究进展进行综述，以求为PJI的治疗提供更多的启发。
Abstract
Periprosthetic joint infection (PJI) is a serious complication after joint replacementsurgery. Drug therapy is the basis for the treatment of PJI. However, due to the barrier effect of biofilm and the existence of drug resistance mechanism, the current drug treatment effect of PJI is still not satisfactory. In recent years, bacteriophage therapy has drawn more and more attention. Its application in the treatment of PJI has gradually received attention and some new research ideas and progress have emerged. Bacteriophages are naturally occurring viruses that specifically attack and lyse bacteria. They also have a killing effect on bacteria in biofilms, and are highly specific to bacterial species without affecting human microflora. This article reviewed the research progress of bacteriophage in the treatment of PJI from the aspects of biofilm formation and drug resistance mechanism, bacteriophage biological type and its bactericidal mechanism, the diagnostic effect of bacteriophage on PJI, the advantages and limitations of bacteriophage in the treatment of PJI, and the clinical progress of phage in the treatment of PJI, in order to provide more inspiration for the treatment of PJI.
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