2016-2020年黑龙江省未成年人急、慢性布鲁氏菌病的流行病学及临床特征分析  

Analysis of epidemiological and laboratory results of acute and chronic brucellosis among minors in Heilongjiang from 2016 to 2020

作　　者：索冰 何晶晶 Suo Bing;He Jingjing(Department of Clinical Laboratory,Beidahuang Industry Group General Hospital,Harbin 150088,China)

机构地区：[1]北大荒集团总医院检验科,哈尔滨150088

出　　处：《中华地方病学杂志》2022年第3期226-232,共7页Chinese Journal of Endemiology

基　　金：黑龙江省农垦总局科技局科研课题(HKKYZD191002);黑龙江省卫生健康委员会科研课题(2020-214)。

摘　　要：目的分析黑龙江省未成年人急、慢性布鲁氏菌病(简称布病)的流行病学和临床特征,为未成年人布病的诊断及防治提供依据。方法回顾性分析北大荒集团总医院收治入院的未成年人布病患者的病历资料,选取2016年1月至2020年12月在感染科确诊的150例未成年人布病患者,按临床分型分成急性组125例、慢性组25例;同时选取门诊健康体检者40例作为对照组。分析比较未成年人急、慢性布病患者流行病学特征、临床表现及误诊情况;分析比较未成年人急、慢性组及对照组实验室检测结果[血常规、肝功能、心肌酶、全血C-反应蛋白(CRP)、血培养]。结果2016-2020年未成年人布病在同年总布病患者中占比分别为3.26%(37/1136)、2.50%(28/1119)、3.31%(36/1088)、2.80%(35/1250)、2.00%(14/701)。急、慢性布病患者中,男女比例为1.66∶1.00(78/47)、1.27∶1.00(14/11);学龄期患病率最高[35.2%(44/125),44.0%(11/25)],婴儿期最低[2.4%(3/125)、0(0/25)];3-6月最常见[52.8%(66/125)、44.0%(11/25)];分布在齐齐哈尔市较多[19.2%(24/125)、28.0%(7/25)];易感因素以牛/羊接触最多[89.6%(112/125)、96.0%(24/25)],急性组出现罕见感染因素即哺乳期患病1例。两组出现4种典型症状的分别有32例[25.6%(32/125)]、8例[32.0%(8/25)]。早期发热体温,急性组以高热最常见[41.2%(47/114)];在两组关节疼痛患者中,膝关节痛最常见[50.0%(36/72)、60.0%(12/20)]。急性组出现骨骼肌肉疼痛比例高于慢性组(χ^(2)=4.57,P=0.033),而慢性组出现乏力和关节疼痛比例均高于急性组(χ^(2)=4.49、4.41,P均<0.05)。布病患者被误诊为其他疾病的占57.3%(86/150),急性组占49.3%(74/150),慢性组占8.0%(12/150),其中感冒最常见,占38.0%(57/150)。急性组血培养阳性者比例(38.4%,48/125)明显高于慢性组(16.0%,4/25,χ^(2)=4.62,P=0.038)。与对照组比较,急、慢性组的单核细胞计数、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)�Objective To analyze the epidemiological and clinical features of acute and chronic brucellosis in minors from 2016 to 2020 in Heilongjiang,and to provide evidence for diagnosis,prevention and treatment of brucellosis in minors.Methods A retrospective analysis of the medical records of 150 hospitalized patients with brucellosis in minors from January 2016 to December 2020 was conducted in Beidahuang Industry Group General Hospital.According to clinical classification,125 cases were acute patients and 25 cases were chronic patients.At the same time,40 outpatient physical examination persons were selected as control group.Epidemiological features,clinical presentation and misdiagnosis of acute and chronic brucellosis in minors were analyzed and compared.The results of routine blood test,liver function test,myocardial enzyme test,whole blood C-reactive protein(CRP)and blood culture were analyzed and compared among acute group,chronic group and control group.Results From 2016 to 2020,the proportion of brucellosis in minors was 3.26%(37/1136),2.50%(28/1119),3.31%(36/1088),2.80%(35/1250)and 2.00%(14/701),respectively.In acute and chronic brucellosis,the ratios of male to female were 1.66∶1.00(78/47)and 1.27∶1.00(14/11);the incidence rate was highest in school age[35.2%(44/125),44.0%(11/25)]and lowest in infant[2.4%(3/125),0(0/25)];the disease were most common in March and June[52.8%(66/125),44.0%(11/25)];the more distribution was in Qiqihar[19.2%(24/125),28.0%(7/25)],and the most susceptible factor was contact with cattle and sheep[89.6%(112/125),96.0%(24/25)].In acute group,there was 1 case of lactation infection.There were 32 cases[25.6%(32/125)]and 8 cases[32.0%(8/25)]with four typical symptoms in the two groups.High fever was the most common type in acute group[41.2%(47/114)].Knee pain was the most common type[50.0%(36/72),60.0%(12/20)]in both groups.The incidence of musculoskeletal pain in acute group was higher than that in chronic group(χ^(2)=4.57,P=0.033).The rates of fatigue and joint pain in chronic grou

关 键 词：布鲁杆菌病 未成年人 流行病学特点 

分 类 号：R516.7[医药卫生—内科学] R181.3[医药卫生—临床医学]