652例临床诊断细菌性痢疾患者的流行病学特点

Epidemiology of bacterial dysentery diagnosed clinically in Beijing： analysis of 652 patients

目的探讨北京市近年来成人急性细菌性痢疾的流行病学和临床特点，为肠道传染病的防控提供科学依据。方法以2007年4月至2007年10月北京大学第三医院肠道门诊652例临床诊断急性细菌眭痢疾患者为研究对象，对患者年龄、职业分布、症状体征、病原检测等情况进行分析。结果临床诊断急性细菌性痢疾患者以青壮年发病为多，职业构成以干部职员、学生为主，临床症状以腹泻、腹痛、发热为最常见症状，里急后重、左下腹压痛少见，大便细菌培养阳性率17．7％，细菌性痢疾确诊率8．9％。结论临床诊断急性细菌性痢疾的患者临床和流行病学特点已经发生了一些变化，病原菌培养阳性率低，与其他感染性腹泻不易鉴别，易造成传播。

Objective To investigate the epidemiological and clinical characteristics of acute bacterial dysentery in recent years in Beijing so as to provide scientific reference for prevention and control of enteric infectious diseases. Methods The data of age, occupation, symptoms, signs, pathogen detection of 652 patients with acute bacterial dysentery diagnosed clinically from April 2007 to October 2007 were analyzed retrospectively. Results The occupations of the 652 patients included office workers and functionaries （31.4%）, students （29.4%）, retirees （9.8%）, unemployed and housewives （7.1%）, commercial attendants （6.3）, workers （4.8%）, teachers （4. 1%）, and others （7.1%）. Diarrhea, stomachache, and fever were the main symptoms. Tenesmus and tenderness of left lower quadrant abdomen were infrequent. The positive rate of fecal bacterial culture was 17.7%. 8. 9% of the patients were diagnosed as with bacterial dysentery by fecal bacterial culture. Conclusion Most of the patients with bacterial dysentery in Beijing are young adults. The positive rate of fecal bacterial culture is low. It is difficult to differentiate bacterial dysentery from other diarrheal diseases.