目的: 探索布鲁氏菌病的流行病学特征与临床表现及药物治疗效果。方法: 选取2015年3月至2016年8月住院的33例初治布鲁氏菌病患者为研究对象,对所有患者进行布鲁氏菌血培养、鉴定、血清学试验等,分析其临床表现和治疗效果。结果: 患者年龄20~60岁者占比为69.70 %;男性占81.82 %,女性占18.18 %,男女发病比例为4.5∶1;患者集中于桂阳县,占比为39.39 %;患者集中于牧羊人群,占比为51.52 %。布鲁氏菌病患者多数实验室检查表现为白细胞不高,降钙素原不高,血沉、C反应蛋白异常,乳酸脱氢酶、谷草转氨酶和谷丙转氨酶异常。少数病人肝脾肿大,急性期血培养阳性率高。患者口服利福平、多西环素联合治疗效果好。结论: 本地区布鲁氏菌病患者20~60岁占大多数,男性为主,患者中桂阳县所占比最高,患者中从事畜牧业占多数,大部分患者血培养阳性,口服利福平、多西环素联合治疗效果好。
Objective: To explore the epidemiological characteristics and clinical manifestations of brucellosis and the effects of drug treatment.Methods: 33 cases of newly diagnosed brucellosis patients from March 2015 to August 2016 were selected as the research objects. Brucella blood culture, identification and serological test were made on all the patients and the clinical manifestations and treatment were analyzed.Results: The age distribution between 20~60 years old was 69.70 %. The male incidence rate was 81.82 %, the incidence rate of female was 18.18 %, and the male and female incidence ratio was 4.5:1; the patients concentrated on Guiyang County, which accounted for 39.39 %; the disease often occurred in patients with sheep, which accounted for 51.52 %. The main laboratory examination of brucellosis showed leukocyte was not high, procalcitonin was not high, ESR and C reactive protein were abnormal, and lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase were abnormal. A minority of patients with hepatosplenomegaly had high blood culture positive rate in acute stage. The therapeutic effect of rifampicin and doxycycline was good.Conclusion: The peak age distribution was between 20~60 years old and most of them were male. The highest occurrence place is in Guiyang county and most of the patients are in stock farming. The blood culture of most patients is positive and rifampicin and doxycycline orally are effective.
[1] 靳峰,宋晓佳,胡兴中,等.2004-2010年宁夏人间布鲁氏菌病病例流行病学特征分析[J].宁夏医学杂志,2013,35(1):40-41.
[2] 杨丽,寇增强,毕振旺,等.山东省2004-2012年布鲁氏菌病时空分布特征分析[J].中华流行病学杂志,2014,35(8):925-929.
[3] 王志翔,杨炬,马学平,等.宁夏盐池县布鲁氏菌病就诊人群流行病学调查分析[J].宁夏医科大学学报,2015,37(10):1178-1181.
[4] 张倩倩,查亦薇,陈中文,等.嘉兴市布鲁氏菌病相关职业人群血清流行病学调查[J].预防医学,2016,28(7):714-715,718.
[5] 崔亮亮,谭文文,杭纪红,等.2012年江苏省重点地区职业人群布鲁氏菌病感染现况调查[J].中华流行病学杂志,2013,34(7):686-689.
[6] 许华茹,刘晓雪,张吉山,等.2009-2014年商河县人间布鲁氏菌病监测资料分析[J].现代预防医学,2016,43(19):3611-3614.
[7] 杨小兵,孔德广,周小琦,等.武汉市首例本地人感染布鲁氏菌病确诊病例流行病学调查分析[J].公共卫生与预防医学,2013,24(1):73-74.
[8] 朱鑫,刘英,郭正印,等.洛阳市2004-2015年人间布鲁氏菌病流行特征分析[J].中国医学创新,2016,13(22):59-61,62.
[9] 唐志坚.布鲁氏菌病的流行病学调查及分析[J].中国卫生产业,2015,44(3):7-8.
[10] 李红艳,卢昌宏,关晓丽,等.不明原因发热诊断为布鲁氏菌病的临床分析[J].职业与健康,2014,12(24):3646-3648.