山西省271例布鲁菌病患者临床特点分析

Epidemiological and clinical characteristics of 271 patients with brucellosis in Shanxi Province

目的分析山西省布鲁菌病患者临床特点,为布鲁菌病的临床诊断、用药指导和综合防控提供依据。方法对2020年1月1日至2021年12月31日太原市第三人民医院收治的布鲁菌病确诊患者进行回顾性研究,分析其临床特点、治疗及预后转归等。结果271例布鲁菌病患者的临床表现以发热[64.2%(174/271)]最多见,可有乏力、多汗、头痛及肝脾肿大等全身非特异性表现,以及腰痛、关节肌肉疼痛及睾丸肿痛等器官特异性症状。病程1个月内者最多[32.8%(89/271)]。误诊率为10.7%(29/271)。急性期组与慢性期组比较,血红蛋白(Hb)下降,C反应蛋白(CRP)及红细胞沉降率(ESR)升高,Hb(t=-2.12,P<0.05)、CRP(t=2.15,P<0.05)、ESR(t=2.26,P<0.05)差异均有统计学意义(P<0.05),WBC(t=-0.87,P>0.05)、血小板计数(PLT)(t=-0.84,P>0.05)及降钙素原(PCT)(t=1.11,P>0.05)差异均无统计学意义(P>0.05)。全部患者血培养阳性率(46.1%,125/271),急性期组阳性率(51.0%,121/237)高于慢性期组(11.8%,4/34),二者比较差异有统计学意义(χ^(2)=18.47,P<0.01)。结论山西省布鲁菌病临床特点较前无明显变化,误诊率低,应继续科学防控并加强非感染科医师及基层医师相关知识储备,做到早诊断、早治疗。

Objective To analyze the clinical characteristics of patients with brucellosis in Shanxi Province,and to provide a basis for clinical diagnosis,medication guidance and scientific prevention and control of brucellosis.Methods A retrospective study was conducted on patients diagnosed with brucellosis admitted to the Third People′s Hospital of Taiyuan City from January 1,2020 to December 31,2021,to analyze their clinical characteristics,treatment and prognosis.Results The most common clinical manifestation of 271 patients with brucellosis was fever[64.2%(174/271)].There were systemic non-specific manifestations such as fatigue,sweating,headache,hepatosplenic enlargement,and organ specific symptoms such as low back pain,joint muscle pain and testicular swelling and pain.The most cases were reported within one month[32.8%(89/271)].The misdiagnosis rate was 10.7%(29/271).Compared with chronic group,Hb decreased,CRP and ESR increased,Hb(t=-2.12,P<0.05),CRP(t=2.15,P<0.05),ESR(t=2.26,P<0.05)had statistical significance(P<0.05).There were no significant differences in WBC(t=-0.87,P>0.05),PLT(t=-0.84,P>0.05)and PCT(t=1.11,P>0.05).The positive rate of blood culture in all patients was 46.1%(125/271),and the positive rate in acute stage group(51.0%,121/237)was significantly higher than that in chronic stage group(11.8%,4/34),the difference was statistically significant(χ^(2)=18.47,P<0.01).Conclusion The clinical characteristics of brucellosis in Shanxi Province have not changed significantly compared with before,but the misdiagnosis rate is low,so it is necessary to continue scientific prevention and control and strengthen the relevant knowledge reserve of non-infectious physicians and grass-roots physicians,so as to achieve early diagnosis and treatment.