122例急性布鲁菌病患者血培养临床分析

Clinical analysis of 122 acute brucellosis patients＇ blood culture

目的分析急性布鲁菌病（简称布病）患者血培养结果和菌种分型，确定感染种型，进一步探讨布病患者临床表现及治疗效果。方法选取2012、2013年在黑龙江省农垦总局总医院住院的122例（男性83例、女性39例）急性布病患者，年龄在6～73岁，平均年龄36．5岁。所有患者行血培养、血清学检查，并给予氨基糖苷类、喹诺酮类、头孢类抗生素治疗。结果122例布病患者血培养均为羊种布鲁菌．其中羊种3型104例．羊种1型18例。所有受试者的血清学虎红平板凝集试验（rose bengal plate agglutination test,RBPT）均为阳性：血清试管凝集试验（serum tube agglutination test，SAT）各个效价在羊种1型和3型均匀分布，羊种1型主要集中在1：800效价区，羊种3型主要集中在1：400效价区：羊种1型与羊种3型的抗人球蛋白及半胱氨酸分布趋势相似，抗人球蛋白主要集中在1：800效价区，半胱氨酸主要集中在1：40效价区。所有患者均有典型的布病症状，并发症多（如脊柱炎、中毒性肝炎等）。122例急性布病患者经治疗112例痊愈，10例好转。结论黑龙江省人间布病由羊种菌1、3型引起，临床症状重且并发症多，早期诊断、早期治疗才能得到显著治疗效果。

Objective By studying the acute brucellosis patients＇ blood culture and the bacteria strains, we tried to confirm the bacteria strains, and to further explore the symptoms and the results of the treatment. Methods Totally 122 acute brucellosis patients were selected, who were in hospital in Heilongjiang Provincial Nongken General Hospital from 2012 to 2013. The patients aged 6 - 73 years old, whose average age was 36.5 （including 83 males and 39 females）. All of the subjects were detected in the aspects of blood culture and brucellosis serology, all of whom were treated with aminoglycoside, 4-quinolones and cephalosporins. Results All the subjects were Brucella melitensis biovar, of which 104 were Brucella melitensis biovar 3, 18 were Brucella melitensis biovar 1. All of them had positive results in rose bengal plate agglutination test （RBPT）. In serum tube agglutination test （SAT）, the valence of Brucella melitensis biovar 1 and 3 were uniformly distributed, Brucella melitensis biovar 1 was distributed mainly in 1 ： 800 valence zone, Brucella melitensis biovar 3 was distributed mainly in 1 ： 400 valence zone. The distribution trends in Coombs test and complement fixation test （CFT） were similar. In Coombs they were distributed mainly in 1 ： 800 valence zone, and in CFY were distributed mainly in 1 ： 40 zone. All of the subjects had typical symptoms of brucellosis, and had various kinds of complications （spondylitis, toxipathic hepatitis, et al）. Totally 112 of them were recovered, and 10 were improved. Conclusion The human brucellosis in Heilongjiang Province is caused by BruceUa melitensis biovar 1 and 3, with severe symptoms and various kinds of complications, earlier diagnose and treatment will have a better effect.