河南省99例布鲁菌病患者临床特征分析  

Clinical features of 99 cases of brucellosis in Henan Province

作　　者：李华[1] 张志伟 高晓娟[1] 余祖江[1] 李志勤[1] 武淑环[1] 安敬军[1] Li Hua, Zhang Zhiwei, Gao Xiaojuan, Yu Zujiang, Li Zhiqin, Wu Shuhuan, An Jingjun(1 Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China ; 2Department of Critical Medical Care, Zhengzhou Central Hospital, Zhengzhou 450007, China)

机构地区：[1]郑州大学第一附属医院感染科,郑州450052 [2]郑州市中心医院重症医学科,郑州450007

出　　处：《中华地方病学杂志》2018年第5期402-405,共4页Chinese Journal of Endemiology

摘　　要：目的 分析河南省布鲁菌病（布病）患者的临床资料，为布病患者的高效治疗提供依据。方法 收集2013年1月至2016年6月在郑州大学第一附属医院住院的布病患者病例资料，回顾性分析布病患者的临床表现、实验室检查、诊断方法及治疗效果。结果 共收集布病患者99例，平均年龄为（46.7 ± 15.7）岁，其中有羊接触史者83例，有猪接触史者2例，有牛接触史者1例。按职业分布，有农民90例、兽医1例、厨师2例、儿童及学生6例。所有患者均有发热、乏力、多汗等临床表现；伴有腰背部及关节疼痛的患者18例，其中，有13例患者受累的椎体、附件、椎间盘、关节磁共振成像（MRI）呈现异常。血培养阳性者54例（71.05%，54／76），血清试管凝集试验阳性者61例（98.39%，61／62）。81例布病患者接受多西环素联合利福平治疗方案，停药半年后随访，所有患者痊愈。结论 羊是布病的主要传染源，发热、多汗、乏力是布病患者的主要症状，并发症多见于骨关节异常。血清试管凝集试验及血培养是诊断布病的重要检查手段。多西环素联合利福平是有效治疗布病的首选方案，早期、联合、规律、全程的抗菌药物治疗预后效果更好。Objective To analyze the clinical data of brucellosis, and to provide references for brucellosis therapy. Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2016 were assessed, data of clinical features, laboratory examination, treatment and prognosis were analyzed. Results Of all 99 cases, the mean age was （46.7 ± 15.7） years old, 83 cases had a history of closely contacted with sheep, 2 cases with pig and 1 case with cattle. The occupational distribution of patients included 90 farmers, 1 veterinarian, 2 cooks, 6 children and students. All patients had clinical manifestations such as fever, fatigue, and sweating. There were 18 patients with back and joint pain, 13 cases had abnormal manifestation on magnetic resonance imaging （MRI）. Blood culture was positive in 54 （71.05%,54/76） and serum test tube agglutination test was positive in 61 （98.39%,61/62）. Eighty-one patients received doxycycline combined with rifampicin treatment, six months laters, all patients were cured. Conclusions Sheep are the main sources of infection for brucellosis. Fatigue, sweaty and fever are the most common symptoms, and osteoarticular is the most frequently involved. Serum agglutination test and blood culture are important tests for diagnosis of brucellosis. Doxycycline combined with rifampicin was the most common used antibiotics regimen. Early, combined, regular, full-course antibiotic treatment has a better prognosis.

关 键 词：布鲁菌病 临床特征 治疗方案 

分 类 号：R516.7[医药卫生—内科学]