34例布鲁氏菌病患儿流行病学及临床特征分析

Epidemiological and clinical characteristics of 34 children with brucellosis

目的了解布鲁氏菌病(简称布病)患儿的流行病学及临床特征,以期为临床诊治儿童布病提供参考。方法回顾性收集2020年12月至2022年12月在北大荒集团总医院感染科就诊的布病患儿(年龄≤14岁)的临床资料,对其流行病学特征、临床特征、实验室检查及治疗与转归等情况进行总结分析。结果共纳入布病患儿34例,其中男性25例(73.53%)、女性9例(26.47%),男女性别比为2.78∶1.00;年龄中位数为8岁1个月,主要集中在6~14岁年龄组(19例,55.88%)。流行病学调查显示,患儿多为农村居住者(25例,73.53%),接触牛/羊者较多(26例,76.47%),发病时间主要集中在夏季(15例,44.12%)和春季(13例,38.24%)。临床症状以发热(97.06%,33/34)和关节痛(64.71%,22/34)为主。实验室检查中,25例(73.53%)患儿血培养阳性,30例(88.24%)患儿白细胞计数(WBC)为(4~10)×10^(9)/L;肝功能异常指标中,天门冬氨酸氨基转移酶(AST)升高19例(55.88%),丙氨酸氨基转移酶(ALT)升高14例(41.18%),γ-谷氨酰转肽酶(GGT)升高6例(17.65%)。心肌酶学异常指标中,α-羟丁酸脱氢酶(HBDH)升高29例(85.29%),乳酸脱氢酶(LDH)升高27例(79.41%),肌酸激酶同工酶(CK-MB)升高8例(23.53%)。经过治疗,25例血培养阳性患儿均转为阴性。结论布病患儿以男性、高年龄、农村居住者为主;临床表现以发热和关节痛为主。相关科室医生在临床工作中应针对此类患儿采取详细的流行病学调查以及相关实验室检查,实现儿童布病的早发现、早诊断、早治疗。

Objective To learn about the epidemiological and clinical characteristics of children with brucellosis,in order to provide reference for clinical diagnosis and treatment of brucellosis in children.Methods Clinical data of children with brucellosis(aged≤14 years)who visited the Department of Infectious Diseases at Beidahuang Industry Group General Hospital from December 2020 to December 2022 were retrospectively collected,and their epidemiological characteristics,clinical characteristics,laboratory tests,treatment and outcome were summarized and analyzed.Results A total of 34 children with brucellosis were included,including 25 males(73.53%)and 9 females(26.47%),with a gender ratio of 2.78∶1.00.The median age was 8 years and 1 month,mainly in the age group of 6 to 14 years(19 cases,55.88%).Epidemiological investigation showed that most of the affected children were rural residents(25 cases,73.53%),with more contact with cattle/sheep(26 cases,76.47%).The onset time was mainly concentrated in summer(15 cases,44.12%)and spring(13 cases,38.24%).The clinical symptoms were mainly fever(97.06%,33/34)and arthralgia(64.71%,22/34).In the laboratory tests,25 cases(73.53%)had positive blood cultures,and the white blood cell count(WBC)of 30 cases(88.24%)was(4-10)×10^(9)/L.Among the abnormalities of liver function,aspartate aminotransferase(AST)increased in 19 cases(55.88%),alanine aminotransferase(ALT)increased in 14 cases(41.18%)andγ-glutamyl transpeptidase(GGT)increased in 6 cases(17.65%).Among the myocardial enzymatic abnormalities,α-hydroxybutyrate dehydrogenase(HBDH)increased in 29 cases(85.29%),lactate dehydrogenase(LDH)increased in 27 cases(79.41%),and creatine kinase isoenzyme(CK-MB)increased in 8 cases(23.53%).After treatment,25 children with positive blood culture turned negative.Conclusions Children with brucellosis are mainly male,older and rural residents.The clinical manifestations are mainly fever and arthralgia.Doctors in relevant departments should conduct detailed epidemiological investigations and laboratory tests for such children in clinical work,in order to achieve early detection,diagnosis and treatment of pediatric brucellosis.