28例急性布鲁杆菌病患者血清学动态检测结果及临床意义  

The dynamic serological test results of 28 patients with acute brucellosis and clinical significance

作　　者：于占水[1] 程大伟[1] 陈雪英[1] 谢福杰[1] 李福兴[1] 

机构地区：[1]黑龙江省农垦总局总医院布鲁杆菌病科,哈尔滨150088

出　　处：《中华地方病学杂志》2013年第1期88-90,共3页Chinese Journal of Endemiology

摘　　要：目的观察28例急性布鲁杆菌病（简称布病）患者血清学动态检测结果，探讨布病血清学检测对疾病临床诊断、疗效评价及预后判断的意义。方法以黑龙江省农垦总局总医院布病科确诊收治的28例急性布病患者（由同一实验室感染羊种布病）作为观察对象，于治疗前，治疗第3、6．9周观察其临床症状体征（包括发热、乏力、多汗、关节疼痛、淋巴结肿大）及生化指标[谷丙转氨酶（ALT）、乳酸脱氢酶（LDH）]，应用试管凝集试验（SAT）测定观察对象血清学抗体效价，并与临床转归进行对比研究。结果28例急性布病患者以治疗第3周时SAT试验检测抗体效价为最高峰，集中在1：400（＋＋），占39．29％（11／28）；而治疗第6周时有28．57％（8／28）转阴；治疗第9周时有50．00％（14／28）转阴。治疗前发热20人（71．43％）、乏力17人（60．71％）、多汗8人（28．57％）、关节疼痛28人（100．00％）、淋巴结肿大7人（25．00％）、ALT升高28人（100．00％）、LDH升高26人（92．86％）；治疗第3周时，除3人（10．71％）偶有低热外，其余患者体温恢复正常，乏力、多汗、关节疼痛人数有所减少，分别为13人（46．43％）、2人（7．14％）、21人（75．OO％），而ALlT、LDH基本恢复正常（仅有1人AIIT升高）；治疗第6周，全部患者发热、多汗临床体征消失，关节疼痛及淋巴结肿大人数减少，分别为12人（42．86％）、3人（10．71％），生化指标ALT、LDH全部正常；治疗第9周，多数患者主要临床症状体征消失，少数患者仍诉有乏力[2人（7．14％）]、关节疼痛[6人（21．43％）]。结论经过有效治疗，抗体效价迅速降低，临床症状很快得到改善，二者之间大致呈平行关系，提示布病特异性抗体出现的早晚、抗体滴度的高低及消长的速度不仅可用于疾病诊断，而且对疗效评价及预后判Objective To observe the dynamic serological test results of 28 patients with acute brucellosis, and to investigate the relationship between serological test results ~and diagnosis, curative effect and prognosis of brucellosis. Methods Twenty eight patients （infected with sheep brucellosis） with acute brucellosis in the Department of Brucellosis in Heilongjiang Provincial Land Reclamation Headquarters General Hospital were selected as research subjects, and their serological changes were tested by means of tube agglutination test（SAT） and clinical outcomes were compared before and after each stage of treatment. In addition, symptoms of fever, weakness, sweating, joint pain, swollen lymph nodes and biochemical parameters[alanine aminotransferase（ALT）, lactate dehydrogenase （LDH） ] were also tested 3, 6 and 9 weeks after the treatment. Results Antibody titer reached the peak at the third week, 1 ： 400（＋＋）, which accounted for 39.29%（11/28） ; 28.57%（8/28） of the patients became negative at the sixth week; 50.00% （14/28） became negative at the ninth week. Before the treatment, 20 （71.43%） patients had the symptom of fever, 8 （28.57%） patients had the symptom of hyperhidrosis, 28 （100.00%） patients had the symptom of joint pain, 7（25.00%） patients had the symptom of lymph node enlargement, 28 （100.00%） patients＇ ALT was elevated, and 26 （92.86%） patients＇ LDH was elevated. After three weeks of treatment, except the three patients （10.71%） who occasionally had fever, the rest of the patient＇s temperature was returned to normal. Also the numbers of patients with the symptoms of fatigue, sweating and joint pain were significantly reduced, and specifically, the corresponding number was 13（46.43%）, 2（7.14%）, and 21（75.00%） patients, respectively. ALT and LDH returned to normal（only one patient＇s ALT was out of the range）. At the sixth week, all the patients＇ symptoms of fever and hyperhidrosis disappeared. The number of patients wit

关 键 词：布鲁杆菌病 血清学 数据收集 

分 类 号：R516.7[医药卫生—内科学]