成人布鲁菌病患者血脂异常状况及关联因素分析  

Analysis of dyslipidemia and related factors in adult patients with brucellosis

作　　者：李彪 李慕瑾妍 杨慧欣 张晟嘉 再依努尔 李金月 甄清[1] 张鹏 Li Biao;Li Mujinyan;Yang Huixin;Zhang Shengjia;Zaiyinuer;Li Jinyue;Zhen Qing;Zhang Peng(Department of Epidemiology and Biostatistics,School of Public Health,Jilin University,Changchun 130021,China;Radiology department,Liaoning Provincial Hospital of Infectious Diseases,Shenyang 110003,China)

机构地区：[1]吉林大学公共卫生学院流行病学与医学统计学系,长春130021 [2]辽宁省传染病医院放射科,沈阳110003

出　　处：《中华地方病学杂志》2020年第11期815-820,共6页Chinese Journal of Endemiology

基　　金：吉林省科技发展计划项目(20191102007YY);吉林大学“大学生创新创业训练计划”国家级资助项目(201910183102)。

摘　　要：目的了解成人布鲁菌病(布病)患者临床特征及血脂谱的异常情况,分析布病患者发生血脂异常的关联因素,为预防和控制布病患者血脂异常的潜在风险提供参考。方法收集2015年1月1日至2016年12月31日辽宁省传染病医院确诊的所有成人布病住院患者临床病历资料,对患者一般人口学特征、接触史、临床分期与病程、伴发慢性疾病等基本情况及血脂异常情况进行描述性分析;采用单因素和多因素非条件logistic回归模型分析布病患者血脂异常的关联因素。结果共收集562例布病患者,年龄为(48.59 ± 12.26)岁,范围为18~76岁,男女性别比为2.5∶1.0(402∶160);其中,仅有牛接触史者193例(34.3%)、仅有羊接触史者331例(58.9%)。在562例布病患者中,伴有血脂异常者共314例,占55.9%;其中总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)异常者分别为48(8.5%)、152(27.0%)、60(10.7%)、217例(38.6%)。logistic回归分析结果显示,糖尿病[比值比(OR)= 4.201,95%置信区间(CI):1.361~12.971]、中性粒细胞升高(OR = 2.314,95%CI:1.981~5.462)、丙氨酸氨基转移酶升高(OR = 2.188,95%CI:1.379~3.473)、降钙素原升高(OR = 1.707,95%CI:1.515~2.532)、牛接触史(OR = 2.170,95%CI:1.464~3.125)为布病患者发生血脂异常的危险因素;中性粒细胞降低(OR = 0.458,95%CI:0.232~0.904)是布病患者发生血脂异常的保护因素。结论布病患者血脂异常率较高,糖尿病、炎症、肝功能异常、牛接触史是布病患者发生血脂异常的相关因素,应采取针对性措施预防并控制布病患者血脂异常的潜在风险,以降低布病及非传染性慢性疾病共病负担。Objective To understand the characteristics of brucellosis in adults and the abnormality of blood lipid profile,and to analyze the related factors of dyslipidemia in brucellosis patients,so as to provide reference for preventing and controlling the potential risk of dyslipidemia in brucellosis patients.Methods The clinical data of all hospitalized patients with brucellosis diagnosed in Liaoning Provincial Hospital of Infectious Diseases from January 1,2015 to December 31,2016 were collected.Patients'general demographic characteristics,exposure history,clinical stage and course of disease,concomitant chronic diseases and other basic conditions and dyslipidemia were analyzed;single factor and multivariate unconditional logistic regression models were used to analyze the related factors of dyslipidemia in patients with brucellosis.Results A total of 562 cases with brucellosis were collected,aged(48.59±12.26)years old,ranging from 18 to 76 years old,and the male to female ratio was 2.5:1.0(402:160);among them,193 cases(34.3%)had a history of contact with cattle and 331 cases(58.9%)had a history of contact with sheep.Among the 562 cases of brucellosis,314 cases(55.9%)were accompanied with dyslipidemia,48(8.5%),152(27.0%),60(10.7%)and 217(38.6%)with abnormal total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C),respectively.The results,of logistic regression analysis showed that diabetes[odds ratio(OR)=4.201,95%confidence interval(CI):1.361-12.971],elevated neutrophils(OR=2.314,95%CI:1.981-5.462),elevated alanine transferase(OR=2.188,95%CI:1.379-3.473),increased procalcitonin(OR=1.707,95%CI:1.515-2.532),history of contact with cattle(OR=2.170,95%CI:1.464-3.125)were risk factors of dyslipidemia in patients with brucellosis;and neutropenia(OR=0.458,95%CI:0.232-0.904)was a protective factor.Conclusions The incidence of dyslipidemia in brucellosis patients is high.Diabetes,inflammation,abnormal liver function,and history contact with cattle are rel

关 键 词：布鲁杆菌病 血脂异常 相关因素 

分 类 号：R516.7[医药卫生—内科学]