2020-2022年陕西省布鲁氏菌病患者的调查分析  

Investigation and analysis of brucellosis cases in Shaanxi Province from 2020 to 2022

作　　者：罗波艳 聂守民 范锁平[1] 任翠翠 安翠红[1] 王文静 周地佳 孙养信[1] Luo Boyan;Nie Shoumin;Fan Suoping;Ren Cuicui;An Cuihong;Wang Wenjing;Zhou Dijia;Sun Yangxin(Institute for Plague and Brucellosis Control and Prevention,Shaanxi Provincial Center for Disease Control and Prevention,Xi'an 710054,China;Department for Plague and Brucellosis Control and Prevention,Yulin City Center for Disease Control and Prevention,Yulin 719000,China)

机构地区：[1]陕西省疾病预防控制中心鼠疫与布病防控所,西安710054 [2]榆林市疾病预防控制中心鼠疫布病防治科,榆林719000

出　　处：《中华地方病学杂志》2024年第5期360-365,共6页Chinese Journal of Endemiology

基　　金：陕西省重点研发计划项目(2024SF-YBXM-274、2018SF-001)

摘　　要：目的了解陕西省人间布鲁氏菌病(布病)流行病学和临床特征,为布病防控提供参考依据。方法通过中国疾病预防控制信息系统和陕西省布病防控工作系统,分别收集2020-2022年陕西省人间布病病例报告资料和病例个案调查资料,对疫情的流行特征及病例的暴露史和临床表现等进行描述性分析。结果2020-2022年,陕西省共报告人间布病病例4240例,无死亡病例,年均发病率为3.60/10万,平均增长速度为22.33%。全年1-12月均有布病病例报告,主要以4-8月为主,占63.40%(2688/4240)。12个地市(包含杨陵区、省直管县级行政区划)均有布病病例报告;90个县(区、市)有布病病例报告,占县(区、市)总数的79.65%(90/113)。病例男女性别比为2.92∶1.00(3159∶1081);年龄以30~74岁为主,占89.81%(3808/4240);职业以农民为主,占87.12%(3694/4240)。2020-2022年陕西省共完成了4223例布病病例的个案流行病学调查,病例病程分期以急性期为主,占94.67%(3998/4223);住院治疗的病例占59.79%(2525/4223);从事布病相关风险职业以饲养、放牧为主,占78.43%(3312/4223)。暴露途径以经皮肤黏膜直接接触和呼吸道感染为主,占95.07%(4015/4223);有4015例有牲畜及其制品接触史,其中接触牲畜种类以羊为主(占96.91%,3891/4015),可能感染地点以家中为主(占58.53%,2350/4015)。主要临床症状为发热、肌肉关节疼痛、乏力和多汗,分别占75.49%(3188/4223)、58.23%(2463/4223)、68.17%(2879/4223)和63.65%(2688/4223)。共分离培养出139株布鲁氏菌菌株,菌型以羊3型为主,占75.54%(105/139)。结论陕西省布病疫情呈现明显的上升趋势,疫情波及范围较广。发病以散养户为主,病程多为急性期,主要通过皮肤黏膜直接接触和呼吸道感染,临床表现多样但无特异性。要切实提升高危人群的个人防护意识和防护水平,以减少布病疫情的发生。Objective To learn about the epidemiological and clinical characteristics of human brucellosis in Shaanxi Province,and to provide reference for brucellosis prevention and control.Methods Through the China Disease Control and Prevention Information System and the Shaanxi Provincial Brucellosis Prevention and Control Work System,report data and case investigation data on human brucellosis cases in Shaanxi Province from 2020 to 2022 were collected,respectively,and the epidemiological characteristics,exposure history and clinical manifestations of the cases were analyzed descriptively.Results A total of 4240 human cases of brucellosis were reported in Shaanxi Province from 2020 to 2022,with no death.The average annual incidence was 3.60/100000,with an average growth rate of 22.33%.Cases of brucellosis were reported from January to December throughout the year,mainly from April to August,accounting for 63.40%(2688/4240).Cases of brucellosis were reported in 12 prefectures(including Yangling District and prefecture-level administrative divisions directly administered by the province)and 90 counties(districts and cities),accounting for 79.65%(90/113)of the total number of counties(districts and cities).The male to female ratio of the cases was 2.92∶1.00(3159∶1081).The onset age was mainly from 30 to 74 years old,accounting for 89.81%(3808/4240).Farmer was the main occupation,accounting for 87.12%(3694/4240).A total of 4223 cases were investigated in Shaanxi Province from 2020 to 2022,with the acute phase being the main stage of disease progression,accounting for 94.67%(3998/4223);hospitalized cases accounted for 59.79%(2525/4223);the main risk occupations of brucellosis were rearing and grazing,accounting for 78.43%(3312/4223).The main exposure routes were direct contact through skin and mucous membranes and respiratory infection,accounting for 95.07%(4015/4223).There were 4015 cases with a history of contact with livestock and their products,with sheep being the main type of contact(accounting for 96.91%,3891/4015)

关 键 词：布鲁氏菌病 疫情 临床表现 防控 

分 类 号：R516.7[医药卫生—内科学]