布鲁杆菌性骨关节损害的流行病学及临床特征分析

Epidemiological and clinical features of brucellosis with osteoarticular injury

目的分析布鲁杆菌性骨关节损害的流行病学及临床特征。方法回顾性分析66例布鲁杆菌病患者的临床资料,其中并发骨关节损害16例(A组),未并发骨关节损害50例(B组),比较两组患者在流行病学、临床症状及体征、实验室检查、治疗效果等方面的差异。结果 A组患者发病例数以4月份为多(5例),B组以5月份为多(6例);B组患者农民的比例明显高于A组(P<0.05);两组患者性别、年龄、动物接触史比较,差异均无统计学意义(均P>0.05)。A组患者收住骨科、骨关节疼痛的比例均高于B组(均P<0.05);两组患者发病到确诊时间及急性期获得诊断、发热、多汗、淋巴结肿大、肝脏肿大、脾脏肿大的比例比较,差异均无统计学意义(均P>0.05)。两组患者试管凝集试验阳性率、血培养阳性率以及WBC、C反应蛋白、ESR水平比较,差异均无统计学意义(均P>0.05)。两组患者规范治疗率、复发率比较,差异均无统计学意义(均P>0.05);A组治疗后退热时间明显长于B组(P<0.05)。结论布鲁杆菌病并发骨关节损害较为常见,患者职业为农民的比例较低,收住骨科、骨关节疼痛的比例较高,治疗后退热时间较长。

Objective To analyze the epidemiological and clinical features of brucellosis complicated with osteoarticular injury.Methods Data of 66 patients with brucellosis were analyzed,including 16 cases with osteoarticular injury(group A)and 50 cases without osteoarticular injury(group B).The epidemiological features,clinical symptoms,signs,laboratory findings and therapeutic effects were compared between two groups.Results The peak of disease onset for group A was in April whereas that for group B was in May.The proportion of farmers in group B were higher than that in group A(P<0.05).There was no significant difference in sex,age and animal contact history between the two groups(P>0.05).Compared to group B,patients in group A were more admitted in department of orthopedics and tended to have bone joint pain(P<0.05).There was no significant difference in time from onset to diagnosis,and confirming the diagnosis at acute phase,in symptoms and signs of fever,hyperhidrosis,lymphadenopathy,hepatomegaly and splenomegaly between the two groups(P>0.05).There was no statistically significant difference in tube agglutination test,blood culture,peripheral white blood cells,C-reactive protein and erythrocyte sedimentation rate between group A and group B(P>0.05).Also there was no statistically significant difference in normative treatment rate and recurrent rate between the two groups(P>0.05).Patients in group A had longer defervescence time than in group B(P<0.05).Conclusion Brucellosis is often complicated by osteoarticular injury.Osteoarticular injury is fewer likely to occur in farmers.Patients with osteoarticular injury tended to have more bone joint pain,admission in department of orthopedics and longer defervescence time after treatment.