人间布病抗菌治疗效果及其影响因素分析

Study on the effectiveness of treatment of brucellosis in humans and factors influencing that effectiveness

目的了解当前布病的治疗效果,并分析其影响因素,为布病控制措施和治疗方案的改进提供依据。方法以济宁市2014-2015年确诊的布病患者为对象,通过确诊后问卷调查和下一年初的电话随访了解病例的流行病学史和治疗效果等,并分析影响治疗效果的因素。结果 2014-2015年共完成确诊布病患者问卷调查393例,随访313例,随访应答率79.64%;治愈272例,治愈率为86.10%。经统计学分析,发病-确诊间隔时间、服药天数和布病治疗效果存在统计学关联。与发病-确诊间隔时间超过45d的病例相比,间隔时间少于15d的病例治疗效果更好（OR=3.339,95%CI：2.064～5.402）。另外,确诊后服药时间是影响布病治疗的重要因素,坚持较长时间服药比短期服药效果更佳（OR=0.992,95%CI：0.986～0.998）。结论济宁市布病患者治疗效果较好,及时诊断和足疗程治疗是影响布病治疗效果的重要因素。加强对布病高危人群的宣传教育,提高医生诊疗水平,是今后布病防控工作的重点。

Objectives To ascertain the effectiveness of brucellosis treatment and factors influencing that effectiveness in patients and to explore effective methods of controlling and treating human brucellosis. Methods A survey and telephone interviews of patients with brucellosis were conducted from 2014 to 2015in the City of Jining,Shandong Province.A questionnaire was used to collect information on contraction of brucellosis and the effectiveness of treatment,and factors influencing the effectiveness of treatment were analyzed.Data were analyzed using the software SPSS v.20.0. Results In total,393 patients responded to the survey for a rate of response of 79.64%（313/393）.Two hundred and seventy-two patients were cured for a cure rate of about 86.10%.If less than 15 dhad elapsed from when the disease developed until it was definitively diagnosed,treatment was more effective than if more than 45 dhad elapsed from the disease developed until it was definitively diagnosed（OR=3.339,95% CI：2.064-5.402）.If a patient complied with medication for a longer period,treatment was more effective than if the patient complied with medication for a briefer period（OR=0.992,95% CI：0.986-0.998）. Conclusion Human brucellosis is treated effectively in the City of Jining,and patients need to be promptly diagnosed and fully treated.Future efforts to control human brucellosis should improve campaigns and education for at-risk populations,i.e.people exposed to sheep,and especially those birthing livestock.Medical personnel also need to be better trained in diagnosing and treating the disease.