鲁西南地区布鲁菌监测和人布鲁菌病临床分析  

The monitoring of Brucella and clinical analysis of human brucellosis in the southwest of Shandong Province

作　　者：高东田[1] 

机构地区：[1]济宁医学院附属医院检验科,山东济宁272029

出　　处：《检验医学》2016年第7期571-575,共5页Laboratory Medicine

摘　　要：目的了解鲁西南地区人布鲁菌病的流行状况,为制定其防治措施提供依据。方法采用Bac T ALERT 3D120血培养仪和VITEK 2 Compact分析仪对布鲁菌进行培养和鉴定,结合患者病史,进行流行病学调查,采用SPSS 17.0软件进行数据统计。结果 94例患者中男72例（76.6%）、女22例（23.4%）,男女比例为3.27︰1;年龄2~77岁,其中30~60岁者占68.1%。济宁地区76例,占80.9%,其中邹城市和嘉祥县较多;菏泽地区18例,占19.1%,以巨野县和郓城县为主。农民81例,占86.2%。羊接触史者59例,占62.8%。4~6月份发病者占54.3%。呼吸道感染者占56.5%。丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、C反应蛋白（CRP）、降钙素原（PCT）增高者分别为61、59、72和64例。阳性瓶报警多在2~5 d,均为马尔他布鲁菌,鉴定率为91%~99%。利福平、多西环素、左氧氟沙星和米诺环素抗感染治疗选用率分别为100.0%、68.1%、44.7%和31.9%。结论鲁西南地区人布鲁菌病呈散发流行且呈逐年增加态势,开展布鲁菌检测和人布鲁菌病临床分析对该病的临床防治和流行病学研究有重要意义。Objective To analyze the epidemic status of human brucellosis in the southwest of Shandong Province,and to provide a reference for prevention and control. Methods The isolates of Brucella were cultured by Bac T ALERT 3D120 and identified by VITEK 2 Compact. The epidemiological analysis was performed with the case histories of patients. SPSS 17.0 software was used for statistical analysis. Results In 94 patients,there were 72 males（76.6%） and 22 females（23.4%）. The ratio of males to females was 3.27∶1. The ages were from 2 to 77 years,and 68.1% of them were 30-60 years old. There were 76 patients（80.9%） in Jining,mainly from Zoucheng City and Jiaxiang County. There were 18 patients（19.1%） in Heze,mainly from Juye County and Yuncheng County. There were 81 peasants（86.2%）in 94 patients,and 59 patients of them（62.8%）had contact with goats. The occurrence rate was 54.3% from April to June. The patients with respiratory tract infection accounted for 56.5%. There were some high indices,including alanine aminotransferase（ALT）（61 cases）,aspartate aminotransferase（AST）（59 cases）,C-reactive protein（CRP）（72 cases）and procalcitonin（PCT）（64 cases）. The positive alarm always happened in oxygen bottles on the 2nd-5th days. The identification rate of Brucella melitensiswas 91%-99%. The rates for therapies with rifampin,doxycycline,levofloxacin and minocycline were 100.0%,68.1%,44.7% and 31.9%,respectively. Conclusions In the southwest of Shandong Province,human brucellosis is scattered,and there is an increasing trend. The detection of Brucella and clinical analysis of human brucellosis are important for the prevention and treatment of diseases and epidemiological analysis.

关 键 词：布鲁菌 人布鲁菌病 流行病学分析 

分 类 号：R378.5[医药卫生—病原生物学]