儿童布鲁菌病患者的临床特征及实验室检查结果特点分析  

Clinical features and laboratory examination characteristics of children with brucellosis

作　　者：何晶晶[1] 张雁[1] 郑遵荣[1] 赵琳琳[1] 徐育红[1] 周玉珍[1] 赵冬梅[1] 

机构地区：[1]黑龙江省农垦总局总医院检验科,哈尔滨150088

出　　处：《中华地方病学杂志》2017年第5期370-373,共4页Chinese Journal of Endemiology

摘　　要：目的 探讨儿童布鲁菌病（简称布病）患者的临床特征和实验室检查特点，为其临床诊治提供理论依据。方法 采用回顾性分析方法，收集2013年1月至2016年1月在黑龙江省农垦总局总医院感染科确诊的儿童布病患者的临床资料，对其一般特征、临床症状特点、实验室检查等进行总结分析。同时按照病例对照方法选取同时期成人布病患者，对比分析儿童与成人布病患者的实验室检查结果。结果 65例儿童布病患者，以 ＞ 12 ~ 15岁年龄段发病最多，占47.7%（31／65）；临床症状以发热和关节痛居多，分别占83.1%（54／65）和84.6%（55／65）。儿童与成人布病患者γ-谷氨酰基转移酶（γ-GT）、α-羟丁酸脱氢酶（HBDH）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）测定值均数比较差异有统计学意义［（30.66 ± 27.05）比（82.80 ± 36.34）U／L，（287.40 ± 35.02）比（180.08 ± 40.90）U／L，（20.88 ± 13.01）比（11.70 ± 4.13）U／L，（328.69 ± 37.86）比（217.88 ± 45.67）U／L，t = - 4.243、3.396、3.756、3.135，P均 〈 0.05］。经过治疗，儿童布病患者血清天冬氨酸氨基转换酶（AST）、丙氨酸氨基转换酶（ALT）、γ-GT、总蛋白（TP）、白蛋白（ALB）、HBDH、CK-MB、LDH检测结果与治疗前比较差异有统计学意义［（56.95 ± 29.50）比（23.00 ± 12.26）U／L，（57.60 ± 35.65）比（23.94 ± 13.38）U／L，（30.66 ± 27.05）比（18.45 ± 12.62）U／L，（63.77 ± 5.51）比（67.42 ± 3.50）g／L，（39.15 ± 3.89）比（43.06 ± 3.11）g／L，（287.4 ± 35.02）比（139.23 ± 51.70）U／L，（20.88 ± 13.01）比（11.61 ± 10.26）U／L，（328.69 ± 37.86）比（187.77 ± 42.32）U／L，t = 4.848、2.717、2.182、 - 5.442、 - 13.752、6.989、4.749、5.993，P均 〈 0.05］。结论 儿童布病患者肝脏和心肌普遍受损，通过监测心肌酶的变化，可提示临床慎重儿童用药，防止心肌受�Objective To study clinical and laboratory features of children with brucellosis and to provide a theoretical basis for clinical diagnosis and treatment. Methods Using the retrospective analysis method, the clinical diagnosed information of child patients with brucellosis from January 2013 to January 2016 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics, clinical symptoms and laboratory examination results. At the same time, follow the case control method, dadult brucellosis laboratory results were selected, and the laboratory examination results were compared between child and adult patients. Results The children of 〉 12 - 15 years of age had the highest incidence in 65 cases of brucellosis, and the rate was 47.7% （31/65）. Clinical symptoms were fever and joint pain, which accounted for 83.1% （54/65） and 84.6% （55/65）, respectively. The mean values of γ-glutamyl transpeptadase （γ-GT）, α-hydroxybutyric dehydrogenase （HBDH）, creatine kinase isoenzyme （CK-MB） and lactate dehydrogenase （LDH） were compared between child brucellosis and adult brucellosis, and the differences were statistically significant [（30.66 ± 27.05） vs （82.80 ± 36.34）U/L, （287.40 ± 35.02） vs （180.08 ± 40.90）U/L, （20.88 ± 13.01） vs （11.70 ± 4.13）U/L, （328.69 ± 37.86） vs （217.88 ± 45.67）U/L, t = - 4.243, 3.396, 3.756, 3.135, all P 〈 0.05]. After treatment, the test results of children with aspartate transaminase （AST）, alanine aminotransferase （ALT）, γ-GT, total protein （TP）, albumin （ALB）, HBDH, CK-MB and LDH were compared with those of before the treatment, the differences were statistically significant [（56.95 ± 29.50） vs （ 23.00 ± 12.26） U/L, （57.60 ± 35.65） vs （ 23.94 ± 13.38） U/L, （30.66 ± 27.05） vs （18.45 ± 12.62） U/L, （63.77 ± 5.51） vs （67.42 ± 3.50） g/L, （39.15 ± 3.89） vs （43.06 ± 3.11） g/L, （287.40 ± 35.02） vs （1

关 键 词：布鲁菌病 儿童 临床特征 

分 类 号：R446.1[医药卫生—诊断学] R725.1[医药卫生—临床医学]