研究论文

新疆加依墓地人体脊椎溶解的古病理学

  • 高国帅 ,
  • 王安琦 ,
  • 王龙 ,
  • 张全超
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  • 1.吉林大学生物考古实验室,长春 130012
    2.吉林大学考古学院,长春 130012
    3.新疆大学历史学院(历代西北边疆治理研究中心),乌鲁木齐 830000
    4.吐鲁番学研究院,吐鲁番 838000
高国帅,博士研究生,主要从事人类骨骼考古学研究。E-mail: gaoguoshuai0607@163.com
王安琦,讲师,主要从事人类骨骼考古学研究。E-mail: wangaq@xju.edu.cn

收稿日期: 2023-07-30

  修回日期: 2023-10-18

  网络出版日期: 2024-10-10

基金资助

国家社科基金重点项目“加依墓地考古发掘报告”(19AKG005);2023年度哲学社会科学校内培育项目(23CPY039)

Paleopathology of vertebras osteolysis of the person from the Jiayi Cemetery, Xinjiang

  • GAO Guoshuai ,
  • WANG Anqi ,
  • WANG Long ,
  • ZHANG Quanchao
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  • 1. Bioarchaeology Laboratory, Jilin University, Changchun 130012
    2. School of Archaeology, Jilin University, Changchun 130012
    3. School of History (Research Center for Governance of China’s Northwest Frontier in the Historical Periods), Xinjiang University, Urumqi 830000
    4. Turpan Academy, Turpan 838000

Received date: 2023-07-30

  Revised date: 2023-10-18

  Online published: 2024-10-10

摘要

本文对出土于新疆吐鲁番加依墓地青铜至铁器时代的2例罕见脊椎病理性损伤个体,进行了古病理学分析与诊断。经鉴定,个体M172是一名10-12岁的未成年人,个体M167是一名35岁左右的女性,两例个体的脊椎均出现较为严重的骨性溶解病变:终板损坏,内部松质骨溶蚀、吸收,椎体中部空化形成中空现象。其中个体M172除第7胸椎和第3腰椎发生溶解病变之外,手指、耻骨、肩胛骨等多部位均发现局灶性溶骨损伤,肋骨和胫骨局部反应性新骨显著;个体M167的第3、4腰椎由于溶解严重发生椎体塌陷特征。通过CT和X光影像学分析骨骼损伤形态、骨骼损伤区域特征,并结合临床医学资料进行鉴别诊断,认为两例个体患有化脓性骨髓炎、布鲁氏菌病、放射线菌病、骨癌转移以及一些其他真菌感染的可能性较小,推测这两例个体疑似罹患脊柱结核病。

本文引用格式

高国帅 , 王安琦 , 王龙 , 张全超 . 新疆加依墓地人体脊椎溶解的古病理学[J]. 人类学学报, 2024 , 43(05) : 744 -756 . DOI: 10.16359/j.1000-3193/AAS.2024.0011

Abstract

This paper made a paleopathological analysis and diagnosis of two cases of rare vertebras pathological lesions from the Jiayi Cemetery, a Bronze-Iron Age cemetery from Xinjiang, China. We speculated on the most likely type of disease, and at the same time, combined with the living environment of these two individuals, we explored the external factors that caused the patients to become ill. After identification, M172 is a minor of 10-12 years old, and M167 is a female about 35 years old. Two cases showed serious osteolytic lesions in the vertebras: endplate damage, internal cancellus dissolution and absorption. Before the paleopathological diagnosis of bones, we first observed the local bone damage through a super-depth three-dimensional digital microscopic analysis system. We found that there were traces of healing in the bones in the damaged area, thus ruling out the possibility of bone damage caused by buried factors, All skeletal injuries are caused by diseases that the individual suffered from during his or her lifetime. The cavitation of the middle vertebral body had formed hollow phenomenon. In M172, focal lytic lesions were found in hand phalanges, vertebra, pubis and scapulae, ribs and tibia showed significant local new bone formation; the third and fourth lumbar vertebrae of individual M167 showed vertebral collapse due to severe dissolution. Through CT and X-ray imaging analysis of bone injury morphology, bone damage area characteristics, combined with clinical medical data for differential diagnosis, the results suggest that Degenerative arthritis, compression fractures, and Scheuermann disease were excluded because they do not cause osteolytic changes, and two individuals might suffer from spinal tuberculosis, rather than purulent osteomyelitis, brucellosis, actinomycosis, bone cancer metastasis and some other fungal infection. Archaeological excavations of the site show that from the 8th century BC to the 5th century BC, people living in the Turpan area lived a life based on animal husbandry, mainly raising cattle, sheep and horses, which led to their frequent contact with livestock. Cattle are considered to be among the most infectious livestock to humans, including the consumption of meat and dairy products and even the reuse of feces and urine. In addition, backward medical and health factors increase the probability of zoonosis and meet the conditions for the spread of tuberculosis. The Turpan Basin is located in the middle of the Eurasian steppe and was an important location on the ancient Silk Road in China. There were close exchanges between different groups of people. This study is of great significance to the health assessment of the population in the region.

参考文献

[1] Vargová L, Horá?ková L, ?abatová K, et al. Unusual find of osteolytic lesion on skeleton from the Middle Bronze Age: Possible case of peritoneal abscess[J]. International Journal of Osteoarchaeology, 2022, 32: 923-931
[2] Ortner DJ. Identification of Pathological Conditions in Human Skeletal Remains[M]. San Diego: Academic Press, 2003
[3] Robert WM, David RH. 骨骼疾病图谱人类骨骼病理与正常变异指南[M].译者:张全超,秦彦国. 北京: 科学出版社, 2020
[4] 夏洛特·罗伯茨, 基思·曼彻斯特. 疾病考古学[M]. 译者:张桦. 济南: 山东画报出版社, 2010
[5] 王龙, 肖国强, 刘志佳, 等. 吐鲁番加依墓地发掘简报[J]. 吐鲁番学研究, 2014, 1: 1-19
[6] 肖国强. 新疆吐鲁番加依墓地的发现与研究[D]. 西安: 西北大学硕士论文, 2018
[7] 朱泓. 体质人类学[M]. 北京: 高等教育出版社, 2004, 92-106
[8] 邵象清. 人体测量手册[M]. 上海: 上海辞书出版社, 1985, 34-56
[9] Buikstra JE, Ubelaker DH. Standards for Data Collection from Human Skeletal Remains[M]. Fayetteville: Arkansas Archeological Survey, 1994, 15-38
[10] Brooks S, Suchey JM. Skeletal age determination based on the Os pubis: A comparison of the Acsádi-Nemeskéri and SucheyBrooks methods[J]. Human Evolution, 1990, 5: 227-238
[11] Jones C. Brucellosis in an adult female from fate bell rock shelter, Lower Pecos, Texas (4000-1300 BP)[J]. International Journal of Paleopathology, 2009, 24: 252-264
[12] 卞琴, 施杞, 王拥军. 椎体骨赘形成机制的研究进展[J]. 中国中医骨伤科杂志, 2010, 18(5): 63-64
[13] 李法军. 河北阳原姜家梁新时期时代人骨研究[M]. 北京: 科学出版社, 2004
[14] 徐文坚, 袁慧书. 中华影像医学骨肌系统卷(第3版)[M]. 北京: 人民卫生出版社, 2019
[15] 倪立青. 类风湿关节炎[M]. 北京: 中国医药科学技术出版社, 2020
[16] Tony W. Palaeopathology[M]. New York: Cambridge University Press, 2009, 85-89
[17] Carney CN, Wilson FC. Infection of Bones and Joints[C]. In: Wilson FO(Ed). The Musculoskeletal System[M]. Philadelphia: Lippincott, 1975
[18] Stone AC, Ozga AT. Ancient DNA in the study of ancient disease[J]. In: Buikstra JE (Ed). Ortner’S Identification of Pathological Conditions in Human Skeletal Remains[M]. San Diego: Academic Press, 2009, 183-210
[19] 侯代伦, 柳澄. 结核病影像学[M]. 北京: 人民卫生出版社, 2019, 20
[20] 丁惠强, 原文琦. 布鲁杆菌性脊柱炎与脊柱结核的鉴别诊断与治疗[J]. 中华骨科杂志, 2021(20):1484-1492
[21] Tayles N, Buckley HR. Leprosy and Tuberculosis in Iron Age Southeast Asia?[J]. American Journal of Physical Anthropology. 2004, 125: 239-256
[22] Li MC, Charlotte A. Roberts, Chen L, et al. A male adult skeleton from the Han Dynasty in Shaanxi, China (202BC-220AD) with bone changes that possibly represent spinal tuberculosis[J]. International Journal of Paleopathology, 2019, 27: 9-16
[23] 陈雪雯, 卫凤莲, 温海. 隐球菌病的诊治[J]. 皮肤科学通报, 2017, 34(5): 604-612
[24] Bauduer F, Bessou M, Guyomarch P, et al. Multiple calvarial lytic lesions: A differential diagnosis from Early Medieval France (5th to 7th c. AD)[J]. International Journal of Osteoarchaeology, 2014, 24: 665-674
[25] Smith MO. A probable case of metastatic carcinoma from the late prehistoric Eastern Tennessee River Valey[J]. International Journal of Osteoarchaeology, 2002, 12: 235-247
[26] 王虎, 马淑梅, 曹得萍, 等. 青海包虫病研究进展[J]. 青海医学院学报, 1999, 3: 46-50
[27] Hadgaonkar S, Rathi P, Purandare B, et al. Salmonella Typhi dorsolumbar spondylodiscitis mimicking tuberculosis: An interesting case report[J]. Surgical Neurology International, 2020, 11
[28] Stefanovski N, van Voris LP. Pyogenic vertebral osteomyelitis: Report of a series of 23 patients[J]. Contemporary Orthopedics, 1995, 31: 159-164
[29] 吕国义, 彭俊红. X线读片指南[M]. 北京: 北京大学医学出版社, 2016, 248
[30] Aufderheide AC, Rodríguez-Martín C. The Cambridge Encyclopedia of Human Paleopathology[M]. Cambridge: Cambridge University Press, 1998
[31] Roberts CA, Buikstra JE. The Bioarchaeology of Tuberculosis: a Global View on a Reemerging Disease[M]. Gainesville: University Press of Florida, 2003
[32] Pietralata GM, Diotallevi P, Papi MG, et al. “Spina ventosa”: Osservazione di un caso[J]. GIOT, 2003, 29: 186-189
[33] 肯尼思·F, 基普尔. 剑桥世界人类疾病史[M]. 译者:张大庆. 上海: 上海科技教育出版社, 2007, 550-551
[34] 谷野, 张明香, 刘洪艳. 布鲁菌病[M]. 沈阳: 辽宁科学技术出版社, 2019, 84-85
[35] Wong VK, Turmezei TD, Weston VC. Actinomycosis[J]. British Medical Journal, 2011, 34: 785-90
[36] 陈爱凤. 肺放线菌病26例综合临床分析[D]. 杭州: 浙江大学硕士学位论文, 2009, 1
[37] 王宇明, 李梦东. 实用传染病学[M]. 北京: 人民卫生出版社, 2016, 1069
[38] Pritchard DJ. Granulomatous infections of bones and joints[J]. Orthop Clin North Am, 1975, 6: 1029-1047
[39] Marks MK, Hamilton MD. Metastatic Carcinoma: Palaeopathology and Differential Diagnosis[J]. International Journal of Osteoarchaeology, 2007, 17: 217-234
[40] Melikian M. A case of metastatic carcinoma from 18th century London[J]. International Journal of Osteoarchaeology, 2006, 16: 138-144
[41] 廖万清, 吴绍熙. 现代真菌病学[M]. 上海: 复旦大学出版社, 2017, 349
[42] Comas I, Coscolla M, Luo T, et al. Out-of-Africa migration and Neolithic coexpansion of Mycobacterium tuberculosis with modern humans[J]. Nat Genet. 2013, 45(10):1176-1182
[43] 陈贤邦. 中国医学史[M]. 北京: 团结出版社, 2011, 146
[44] 刘永升. 全本黄帝内经[M]. 北京: 华文出版社, 2010, 207-208
[45] Ortner DJ. Paleopathology: Implications for the history and evolution of tuberculosis[C]. In: Palfi G, Dutour O, Deak J, et al. Tuberculosis Past and Present[M]. Golden Book Publisher Ltd, 1999, 255-261
[46] Okazaki K, Takamuku H, Yonemoto S, et al. A paleopathological approach to early human adaptation for wet-rice agriculture: The first case of Neolithic spinal tuberculosis at the Yangtze River Delta of China[J]. International Journal of Paleopathology, 2019, 24: 236-244
[47] Mangtani P, Jolley DJ, Watson JM, et al. Socioeconomic deprivation and rates for tuberculosis in London during 1982-1991[J]. Brit. Med. J, 1995, 310: 963-966
[48] Elender F, Bentham G, Langford I. Tuberculosis mortality in England and Wales during 1982-1992: Its association with poverty, ethnicity and AIDS[J]. Social Science and Medicine, 1998, 46(6): 673-681
[49] 李亚, 李肖, 曹洪勇, 等. 新疆吐鲁番考古遗址中出土的粮食作物及其农业发展[J]. 科学通报, 2013, 58: 40-45
[50] 吴晓桐, 张兴香, 李雍, 等. 新疆吐鲁番加依墓地人类迁徙与饮食结构分析[J]. 西域研究, 2021, 3: 83-91
[51] Zhang WX, Zhang Q, McSweeney K, et al. Violence in the first millennium BCE Eurasian steppe: Cranial trauma in three Turpan Basin populations from Xinjiang, China[J]. Am J Phys Anthropol, 2020, 1-14
[52] 王辉, 贝丽姿, 叶惠媛, 等. 中国古代丝绸之路沿线地区的疾病历史与人群健康[J]. 南方文物, 2023, 1: 281-287
[53] Suzuki T, Inoue T. Earliest evidence of spinal tuberculosis from the aneolithic Yayoi Period in Japan[J]. International Journal of Osteoarchaeology, 2007, 17: 392-402
[54] Garg RK, Somvanshi DS. Spinal tuberculosis: A review[J]. J Spinal Cord Med, 2011, 34 (5): 440-454
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