布鲁菌病218例临床特征分析

目的总结布鲁菌病的流行病学特点和临床特点,为布鲁菌病防治积累临床经验。方法对经ELISA确诊并在本院住院治疗的218例布鲁菌病患者的临床资料（包括流行病学资料、临床表现及实验室检查结果等）进行回顾性分析。结果 218例布鲁菌病患者的发病时间集中在3-8月。76.1%的患者系从事养殖业的农民,以青壮年男性为主,主要经直接接触感染。发热、乏力、多汗、关节疼痛和脾大系常见临床表现,热型多不规则,关节疼痛症状多不典型。可并发骨关节损害、肝脏及心肌损害、睾丸炎、血液指标异常、心内膜炎、脑膜炎等,首诊误诊率为62.3%。结论布鲁菌病临床表现复杂多样,并发症多,易误诊,医师应加强对本病的认识以提高诊疗水平。

Analysis of the clinical characteristics of 218 cases of brucellosis

Objective Objective To summarize the epidemiological and clinical characteristics of brucellosis in order to assemble clinical experience preventing and treating this disease. Methods Clinical data on 218 patients who were admitted to this Hospital from Dec.2010 to Dec.2013 were collected.The diagnosis of brucellosis was confirmed with ELISA based on a titer of 1：160in an agglutination test.Epidemiological data,clinical manifestations,and laboratory results were retrospectively analyzed. Results Of the 218 patients,160（73.4%）were male and 58（26.6%）were female.The mean age of patients was 44.57±14.39 years and 61.5% of the patients were ages 30-60.The disease usually developed between March and August.Of the 218 patients,76.1% were farmers engaged in agriculture and most were male adults who were infected with brucellosis primarily through direct contact.A high fever（61.5）,fatigue（62.2%）,hyperhidrosis（62.4%）,arthralgia（57.8%）,and splenomegaly（23.9%）were the most common clinical manifestations.The type of fever varied and joint pain was often atypical.Only 26patients（11.9%）had a typical undulant fever and only four patients（1.8%）had wandering joint pain.Complications included bone and joint damage（9.2%）,liver injury（6.9%）,myocardial damage（1.4%）,orchitis（6.0%）,abnormal blood indices（56.0%）,endocarditis（0.9%）,and meningitis（0.5%）.The rate of misdiagnosis during the initial visit was 62.3%. Conclusion Brucellosis is frequently seen in clinical settings.This disease often has complex and varied manifestations and it causes serious complications,so clinicians should be more aware of this disease in order to improve the rate at which it is diagnosed and treated.