急性布鲁菌病患者121例流行病学及临床特点分析  

Epidemiological and clinical characteristics of 121 patients with acute brucellosis

作　　者：詹爱琴[1] 向梅 李冰洁[1] 卢丽君 李新梅[3] 左维泽[1] 谢松松[1] 居马百克 ZHAN Aiqin;XIANG Mei;LI Bingjie;LU Lijun;LI Xinmei;ZUO Weize;XIE Songsong;JV Mabaike(Department of Infectious Diseases,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832008,China;Second Division of Xinjiang Corps Yanqi Hospital,Yanqi,Xinjiang 832008,China;Medical Department of First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832008,China)

机构地区：[1]石河子大学医学院第一附属医院感染性疾病科,新疆石河子832008 [2]新疆兵团第二师焉耆医院,新疆焉耆832008 [3]石河子大学医学院第一附属医院医务部,新疆石河子832008

出　　处：《中国热带医学》2020年第4期390-393,共4页China Tropical Medicine

基　　金：石河子大学医学院第一附属医院科研项目(No.YL2016-S017)。

摘　　要：目的分析新疆布鲁菌病患者流行病学及临床特点,以提高诊断水平,做到早期预防。方法选择2015年10月—2019年10月在石河子大学医学院第一附属医院门诊及住院布鲁菌病患者121例,分析入选病例流行病学特征、临床表现、治疗和转归情况。结果确诊为急性期布鲁菌病的121例患者中,男性92例(76.03%),女性29例(23.97%),男、女性别比为3.14∶1.00。病例平均年龄为(44.52±11.78)岁,发病时间主要在4—6月,主要职业是农民,其次是牛羊养殖户,明确与牛羊有接触者79例(65.29%)。发热时间最短为7 d,最长的间断发热3个多月,以下午、夜间明显,低热37.3℃~<38.0℃24例(19.83%),中度热38.0℃~<39.0℃52例(42.98%),≥39.0℃者29例(23.97%),无发热者16例(13.22%)。部分患者出现畏寒、乏力、肌肉关节酸痛、多汗等症状。患者中WBC正常73例(60.33%),WBC增多30例(24.79%),WBC减少18例(14.88%),hsPCR增高82例(67.77%),PCT增高63例(52.07%),ALT增高51例(42.15%),AST增高47例(38.84%),AKP增高38例(31.04%),γ-GT增高45例(37.19%),HB降低13例(10.74%),PLT减少16例(13.22%),ESR增高83例(68.60%)。主要并发症有骨关节炎41例(33.88%),睾丸炎或附睾炎6例(4.96%),中枢神经系统并发症5例(4.13%),心内膜炎或心包炎3例(2.48%)。121例患者经治疗后均治愈,随访无复发。结论急性布病患者中,男性多于女性,发病人群主要是与牛羊有直接接触的农民,主要症状是发热,经过规范治疗后,预后较好。Objective To analyze the epidemiology and clinical features of patients with brucellosis in Xinjiang,in order to improve the understanding and diagnosis of brucellosis and we achieve early prevention.Methods Prospective study design was used,121 patients and inpatients in First Affiliated Hospital,School of Medicine,Shihezi University from October 2015 to October 2019 were selected,and the epidemiological characteristics,clinical manifestations,treatment and outcomes of the selected cases were collected.Results Among the 121 patients diagnosed with acute brucellosis,92 were male(76.03%)and 29 were female(23.97%).The ratio of male to female was 3.14∶1.00,which the male incidence was higher.The average age of the selected cases was(44.52±11.78)years old,and the onset time was mainly from April to June.The main occupations of the selected patients were farmers,followed by cattle and sheep farmers.There were 79 cases(65.29%)of contact with cattle and sheep.Among the 121 patients who were enrolled,105(86.78%)had fever,the shortest fever time was 7 days,and the longest fever time was intermittent fever for more than 3 months.The fever was obvious in the afternoon and night.The lowfever body temperature was 37.3-<38.0℃ in 24 cases(19.83%),the moderate-fever temperature was 38.0-<39.0℃ in 52 cases(42.98%),and the body temperature≥39℃ in 29 cases(23.97%),and there were 16 cases with no fever(13.22%).Some patients had symptoms such as chills,fatigue,muscle and joint pain,and sweating.Among the selected patients,WBC was normal in 73 cases(60.33%),WBC increased in 30 cases(24.79%),WBC decreased in 18 cases(14.88%),hsPCR increased in 82 cases(67.77%),PCT increased in 63 cases(52.07%),ALT increased in 51 cases(42.15%),AST increased in 47 cases(38.84%),AKP increased in 38 cases(31.04%),γ-GT increased in 45 cases(37.19%),Hb decreased in 13 cases(10.74%),PLT decreased in 16 cases(13.22%),ESR increased in 83 cases(68.60%).The main complications of brucellosis were osteoarthritis in 41 cases(33.88%),orchitis or epididym

关 键 词：布鲁菌病 急性 并发症 发热 临床特点 

分 类 号：R516.7[医药卫生—内科学]