2009～2018年北京协和医院布鲁菌感染的临床与实验室特点分析  

Analysis of Clinical and Laboratory Features of Brucella Infection in Peking Union Medical College Hospital from 2009 to 2018

作　　者：刘文静[1,2] 孙宏莉 张小江[1,2] 王瑶 杨启文[1,2] 窦红涛 王贺[1,2] 赵颖 郭莉娜[1,2] 刘亚丽 张丽[1,2] 肖盟 徐英春[1,2] LIU Wen-jing;SUN Hong-li;ZHANG Xiao-jiang;WANG Yao;YANG Qi-wen;DOU Hong-tao;WANG He;ZHAO Ying;GUO Li-na;LIU Ya-li;ZHANG Li;XIAO Meng;XU Ying-chun(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730 [2]北京市侵袭性真菌病机制研究与精准诊断重点实验室,北京100730

出　　处：《现代检验医学杂志》2019年第6期126-129,137,共5页Journal of Modern Laboratory Medicine

摘　　要：目的分析布鲁菌感染的临床与实验室特点,为其临床诊治提供依据。方法回顾性分析2009~2018年北京协和医院134例布鲁菌感染患者的临床和实验室资料,对其流行病学特征(包括年龄、性别、接触史、时间分布)、临床表现和疗效进行分析。结果 134例患者中男性88例,女性46例,平均年龄48岁(1~78岁)。50%患者有明确生活在疫区、接触牲畜、生牛羊肉及食用未灭菌奶制品等方面接触史。布鲁菌感染临床表现前三位的症状和体征为发热(66例)、关节痛和/或肌肉痛伴乏力(23例)、心脏疾病(10例)。布鲁菌感染急性期经规范治疗多可治愈,若治疗不及时或不规范可转为慢性。206例送检阳性标本,住院99例、门诊62例和急诊45例。布鲁菌分离前三位的科室为感染内科(49例)、急诊科(34例)和普通内科(11例)。外周血送检比率最高,需氧血培养瓶阳性报警时间均值为88.12h(2~481h)。其他培养阳性标本包括组织、骨髓、脑脊液、关节液和玻璃体等。布鲁菌培养与血清凝集实验结果一致性高,两种方法均送检的有83例,其中82例两种方法均阳性,仅1例培养阳性,血清凝集实验阴性。十年间布鲁菌培养阳性分离率最高的年度是2015~2017年,阳性分离率最高的季节是4月至7月。结论布鲁菌感染的临床表现复杂,分离出布鲁菌是确诊的依据之一,需要综合考虑患者的基本情况和药物的毒副作用选择药物。掌握布鲁菌感染的临床和实验室特征十分重要。Objective The clinical and laboratory characteristics of Brucella infection were analyzed to provide basis for clinical diagnosis and treatment. Methods The clinical and laboratory data of 134 patients with Brucella infection in Peking Union Medical College Hospital from 2009 to 2018 were retrospectively analyzed. The epidemiological characteristics(including age, sex, contact history, time distribution), clinical manifestations and therapeutic effects were analyzed. Results In the134 Brucellosis patients, 88 were male and 46 were female with an average age of 48 years(1~78 years). Only 50% of the patients had a clear history of living in epidemic areas, contact with livestock, raw beef and mutton, and eating unsterilized dairy products. The first three clinical symptoms and signs were fever(66 cases), arthralgia and muscle pain with fatigue(23 cases), and heart disease(10 cases). Most cases of acute Brucella infection could be cured by standard treatment. If the treatment was not timely or standardized, they could become chronic. 206 positive samples distribution was 99 in hospital, 62 in outpatient department and 45 in emergency department, respectively. The top three departments of Brucella infection were infectious medicine(49 cases), emergency medicine(34 cases) and general medicine(11 cases). Peripheral blood was the highest isolated sample type, the average alarm time of aerobic blood culture bottle was 88.12 h(2~481 h). Brucella was also isolated from other sample types such as tissues, bone marrow, cerebrospinal fluid, joint fluid and vitreous body. Brucella culture and serum agglutination test was in high consistency, only one of 83 patients with two methods was positive in culture but negative in serum agglutination test. The highest positive isolation rate of Brucella in the past ten years was from 2015 to 2017, and the highest positive isolation season was from April to July. Conclusion The clinical manifestations of Brucella infection are complex. Isolation of Brucella is one of the bases for its di

关 键 词：布鲁菌 布鲁菌病 凝集实验 流行病学 

分 类 号：R378.5[医药卫生—病原生物学] R446.5[医药卫生—基础医学]