布鲁菌病67例临床特征  

Clinical Characteristics of 67 Cases of Brucellosis

作　　者：曾国芬 庄江锋 高亮 沈堃宇 张杨[1] 苏桂华[2] 高志良[3] 舒欣[3] ZENG Guo-fen;ZHUANG Jiang-feng;GAO Liang;SHEN Kun-yu;ZHANG Yang;SU Gui-hua;GAO Zhi-liang;SHU Xin(Department of Infectious Diseases,The Affiliated Kashi Hospital,Sun Yat-sen University,Kashi 844000,China//Department of Infectious Diseases,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China//Department of Infectious Diseases,The First People’s Hospital of Kashi Prefecture,Kashi 844000,China;The First People’s Hospital of Kashi Prefecture,Kashi 844000,China;Department of Infectious Diseases,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属喀什医院感染科,新疆喀什844000//中山大学附属第三医院感染科,广东广州510630//喀什地区第一人民医院感染科,新疆喀什844000 [2]喀什地区第一人民医院感染科,新疆喀什844000 [3]中山大学附属第三医院感染科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2022年第2期297-304,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省农村科技特派员项目(KTP2020333)。

摘　　要：【目的】分析疫区及非疫区两家三甲医院收治的布鲁菌病(布病)患者的临床特征。【方法】回顾性分析2019年1月至2019年12月中山大学附属喀什医院(喀地一院)及中山大学附属第三医院(中山三院)住院的67例布病患者的临床资料,包括人口学资料、病史、症状、体征、实验室检查及治疗方案,比较两地患者临床表现、实验室检查及治疗选择的差异。【结果】喀地一院、中山三院分别有23例(43.4%)、11例(78.6%)患者具有明确的流行病学史(P=0.019)。发热、乏力、关节疼痛是布病最常见的症状。除了首发纳差症状外,两家医院患者的起病症状大致相同。患者发热、肌肉疼痛发生率及热峰相似,但喀地一院多汗、乏力、关节疼痛、皮疹症状较中山三院常见。两家医院患者均有病例出现肝脾肿大,但均无明显浅表淋巴结肿大。喀地一院、中山三院分别有39例(73.6%)、11例(78.6%)患者发生并发症,院间发生率无统计学差异(P=0.971),且均以肝炎和骨骼损害最常见。中山三院患者脊柱炎(P=0.042)及神经型布病(P=0.041)的发生率高于喀地一院,其余并发症分布无明显统计学差异。喀地一院有7.5%患者使用单药治疗,59.7%使用二联抗菌治疗,均高于中山三院(0、50.0%)。后者使用三联方案的比例高于喀地一院(50.0%vs.11.3%)。【结论】不同地域布病的临床特征总体类似,但在流行病学史、症状、并发症及治疗方案选择上存在部分差异。临床实践中应结合本地病例的特点综合分析,提高布病的认识,减少误诊、漏诊。【Objective】To analyze the clinical characteristics of brucellosis patients from two tertiary hospitals in epi⁃demic and non-epidemic areas.【Methods】The clinical data of 67 brucellosis patients hospitalized in The Affiliated Kashi Hospital of Sun Yat-sen University(Kashi,53)and The Third Affiliated Hospital of Sun Yat-sen University(Guang⁃zhou,14)from January 2019 to December 2019 were retrospectively reviewed,including demographic data,medical his⁃tory,symptoms,signs,laboratory tests and treatment,and the differences between the two groups were compared.【Re⁃sults】There were 23 patients in Kashi and 11 patients in Guangzhou with definite epidemiological history,respectively(P=0.019).Fever,fatigue and arthralgia were the most common symptoms of brucellosis.In addition to anorexia,the on⁃set symptoms of patients in the two hospitals were roughly the same.The incidence of fever,muscle pain and fever peak was similar,but the symptoms of hyperhidrosis,fatigue,arthralgia and rash in Kashi were more common in Guangzhou.There were cases of hepatosplenomegaly in both hospitals,but there was no obvious superficial lymphedema.Complica⁃tions occurred in 39(73.6%)and 11(78.6%)patients in Kashi and Guangzhou,respectively,with no statistical difference(P=0.971),and hepatitis and bone damage were the most common.The incidence of spondylitis(P=0.042)and neurode⁃generative brucellosis(P=0.041)in Guangzhou was higher than that in Kashi,and there was no significant difference in other complications.Of the patients in Kashi,7.5%were treated with single antibiotics,and 59.7%were with dual thera⁃py,which were higher than those in Guangzhou(0,50.0%).The proportion of the triple scheme in Guangzhou was higher than that of Kashi(50.0%vs.11.3%).【Conclusions】The clinical characteristics of brucellosis in different regions are generally similar,but there are some differences in epidemiological history,symptoms,complications and treatment op⁃tions.The characteristics of local cases should be concerned in clini

关 键 词：布鲁菌病 临床特征 

分 类 号：R515.9[医药卫生—内科学]