71例复发性布鲁氏菌病的流行病学与临床调查报告  

Epidemiological investigation and clinical report on 71 cases with recurring brucellosis

作　　者：郭正印[1] 吕家锐[2] 郝宗宇[2] 闫素婷[1] 李铁川[1] 

机构地区：[1]河南省洛阳市疾病预防控制中心传染病预防控制所,河南洛阳471023 [2]河南省疾病预防控制中心传染病预防控制所,郑州450016

出　　处：《疾病预防控制通报》2013年第2期57-59,69,共4页Bulletin of Disease Control & Prevention(China)

摘　　要：目的对比分析71例复发性布鲁氏菌病病例的首次发病和复发的临床与流行病学特点,总结布鲁氏菌病的临床防治经验。方法采取回顾性调查法,查阅1983年以来布鲁氏菌病病例复发的门诊治疗记录,详细统计复发患者的流行病学与临床症状和体征、实验室血清学和布鲁氏菌血培养病历资料,分析并整理。结果对比分析病例男60例,女11例,男女之比为5.45∶1;有66例发病2次,有5例多次发病;首次发病血培养6份,阳性5份,复发患者血培养4份,阳性1份;临床上首发病情重,复发病情轻,实验室血清学检测首发病例的抗体滴度高,复发的抗体滴度低。结论布鲁氏菌病首发和复发病例都有十分明显的羊只流行病学接触史,临床表现首发与复发病例也有明显的不同,患者出现布鲁氏菌病性脊柱炎时,腰痛症状十分突出,病程延长;新发病例血清学效价高,血培养阳性率也高,复发病例则相反;首次患布鲁氏菌病后,在传染源存在的情况下,可以再次或多次患病,除部分为复发外,不能排除二次感染发病。Objective To contrastively analyze clinical and epidemiological manifestations of the first onset and recurrent brucellosis of 71 cases,and summarize clinical experiences of brucellosis prevention and control.Methods Retrospective survey method was used to collect the case records of recurring brucellosis treatment by local brucellosis clinic since 1983,and a statistical analysis was conducted to reveal the epidemiological,clinical,and serological characteristics of patients and their blood culture results.Results By comparison,there were 60 cases of the male and 11 cases of the female,with ratio of 5.45∶1.Sixty-six cases were attacked twice and 5 cases were attacked repeatedly for many times.6 samples of the first onset cases were taken blood culture with 5 of the positive,while 4 samples of the recurrent patients were performed blood culture with 1 of the positive.Clinical manifestations of first-time brucellosis were severer than those of recurring brucellosis.The results of laboratory serological test showed that the brucella antibody titer of first-onset patients was higher than that of the recurrent patients.Conclusions Both first-time and recurrent patients has an epidemiological history of contact with sheep or goat.The clinical manifestations of first-onset cases are clearly different from those of recurring cases.The waist pain symptoms of patients with brucellosis spondylitis are very salient,and the course of waist pain becomes longer.The serologic titer of first-onset cases is higher than that of recurring cases,and the positive rate of blood culture of first-onset cases is also higher.With the existence of the source of infection,a first-time patient could suffer from brucellosis for the second time or even more times.In some situations,the recurring brucellosis results from inadequate treatment.But at the same time,the possibility of reinfection could not be excluded.

关 键 词：布鲁氏菌病 首发病例 复发病例 特征 

分 类 号：R516.7[医药卫生—内科学]