浙江省湖州市10例布鲁菌病患者的临床特征分析  

Clinical characteristics of 10 cases of brucellosis in Huzhou City,Zhejiang Province

作　　者：沈宇娟[1] 钟剑锋[1] 童照威[1] 张龙琪[1] 王伟洪[1] Shen Yujuan;Zhong Jianfeng;Tong Zhaowei;Zhang Longqi;Wang Weihong(Department of Infectious Diseases,Huzhou Central Hospital,Affiliated Central Hospital of Huzhou University,Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院湖州师范学院附属中心医院感染科,313000

出　　处：《中华地方病学杂志》2020年第11期821-824,共4页Chinese Journal of Endemiology

基　　金：湖州市科技局公益性技术应用研究(2020GYT13)。

摘　　要：目的分析浙江省湖州市布鲁菌病(以下简称布病)的临床特征,为提高临床医师对布病的认识和诊治水平提供依据。方法收集2014-2019年湖州市中心医院诊治的10例布病患者病例资料,采用回顾性分析方法,对患者的流行病学资料、临床表现、实验室检查结果、影像学检查结果、病原学检查结果、诊疗过程和转归进行总结分析。结果10例布病患者中,男性6例、女性4例,年龄在32~71岁;9例患者有明确羊接触史,1例为食源性感染;主要临床表现为发热(10例),多汗(2例),关节痛(7例);影像学检查脾肿大5例,淋巴结肿大1例,3例患者表现为脊柱炎(其中1例合并椎旁脓肿),2例合并前列腺炎;2例血培养为羊布鲁菌,10例患者布鲁菌抗体检测阳性。治疗药物为多西环素、利福平、左氧氟沙星中的两联或三联,8例患者随访1月余至5年余,预后均较好。结论布病临床特征缺乏特异性,多有合并骨关节炎或泌尿系统疾病,医师应提高警惕,结合流行病学特征,及时进行实验室检测,尽早诊断。Objective To analyze the clinical characteristics of brucellosis in Huzhou City,Zhejiang Province,so as to provide basis for clinicians to improve their understanding and diagnosis and treatment of brucellosis.Methods The data of 10 cases of brucellosis in Huzhou Central Hospital from 2014 to 2019 were collected,and the epidemiological characteristics,clinical manifestations,laboratory examination results,imaging examination results,etiological examination results,diagnosis and treatment process and prognosis were summarized and analyzed by retrospective analysis method.Results Among the 10 patients with brucellosis,6 were males and 4 were females,aged from 32 to 71 years old,and 9 patients had a history of contact with goat,and one case was considered as food borne infection.The main clinical manifestations were fever(10 cases),sweating(2 cases),joint pain(7 cases).In imaging examination,5 cases with splemomegaly,1 cases with lymphadenopathy,3 patients presented with spondylitis(including 1 case with paravertebral abscess)and 2 cases with prostatitis;Brucella was cultured in 2 patients and Brucella antibodies were positive in 10 patients.The treatment drugs included doxycycline,rifampicin and levofloxacin in two or three combinations.Eight patients were followed up for more than 1 month to more than 5 years,and the prognosis was good.Conclusions Brucellosis lacks specificity in clinical features.Most patients with brucellosis are associated with osteoarthritis or urinary system diseases.Physicians should be vigilant,combine epidemiological features,conduct laboratory tests in time,and diagnose as soon as possible.

关 键 词：布鲁杆菌病 非牧区 临床特征 

分 类 号：R516.7[医药卫生—内科学]