摘要
目的探讨海南地区布鲁氏菌病(简称布病)的临床和流行特征以及实验室特点,总结其诊断及治疗经验。方法回顾性分析海南医科大学第二附属医院2019年1月至2023年12月收治的27例布病住院病例的流行病学特点、临床表现、实验室结果、治疗及预后情况。结果27例患者,男女性别比为2.38∶1.00(19∶8)。职业分布以农牧民居多,共21例(77.8%)。21例(77.8%)患者有明确的牛羊及其相关产品接触史,存在家庭聚集现象。18例(66.7%)患者在3-7月发病。患者临床表现缺乏特异性,以发热(24例,88.9%)、头晕头疼(13例,48.1%)和腰背部疼痛(11例,40.7%)为主,部分患者可伴有乏力(8例)、肌肉酸痛(6例)、胸闷(4例)、脾大(6例)等症状和体征。并发症以肺部感染(13例,48.1%)和脊柱受累(11例,40.7%)常见。布鲁氏菌血培养、试管凝集试验、虎红平板凝集试验、脑脊液或关节腔积液培养阳性率分别为76.9%(20/26)、100.0%(21/21)、100.0%(11/11)、3/4。以多西环素和利福平为主的联合方案治疗效果较好,22例患者治愈。结论海南地区为非布病流行疫区,且布病临床表现不特异,应关注该病的流行特征及临床特点,以提高其诊治水平和防控效果。
Objective To investigate the clinical,epidemic and laboratory characteristics of brucellosis in Hainan,and to summarize the experience of diagnosis and treatment.Methods The epidemiological characteristics,clinical manifestations,laboratory results,treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results In 27 cases,the male to female ratio was 2.38∶1.00(19∶8).Occupational distribution was dominated by farmers and herdsmen,with a total of 21 cases(77.8%).Twenty-one patients(77.8%)had a clear history of contact with cattle,sheep,and related products,and there was a phenomenon of family clustering.Eighteen patients(66.7%)developed symptoms from March to July.The clinical manifestations of the patients were lack of specificity,mainly fever(24 cases,88.9%),dizziness and headache(13 cases,48.1%),and low back pain(11 cases,40.7%).Some patients also had symptoms and signs such as fatigue(8 cases),muscle pain(6 cases),chest tightness(4 cases),and splenomegaly(6 cases).Complications commonly included pulmonary infection(13 cases,48.1%)and spinal involvement(11 cases,40.7%).The positive rates of Brucella blood culture,tube agglutination test,Rose Bengal plate agglutination test,and cerebrospinal fluid or joint cavity effusion culture were 76.9%(20/26),100.0%(21/21),100.0%(11/11),and 3/4,respectively.The combination therapy of doxycycline and rifampicin showed good therapeutic effects,and 22 patients were cured.Conclusions Hainan is not an epidemic area of brucellosis,and the clinical manifestations of the disease are not specific.The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.
作者
汪琦
汪宇雁
陈元泽
郑小静
蔡东尧
尹飞飞
杜永国
张丽媛
Wang Qi;Wang Yuyan;Chen Yuanze;Zheng Xiaojing;Cai Dongyao;Yin Feifei;Du Yongguo;Zhang Liyuan(Department of Infectious and Tropical Diseases,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China;The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases,Hainan Medical University,Haikou 571199,China)
出处
《中华地方病学杂志》
北大核心
2024年第12期997-1000,共4页
Chinese Journal of Endemiology
基金
海南省重点研发项目(ZDYF2022SHFZ098)
国家自然科学基金(82060378)
