黑龙江省474例布鲁杆菌病临床特征

Clinical characteristics of 474 brucellosis cases in Heilongjiang Province

目的了解布鲁杆菌病(布病)的流行病学及临床特征,进一步加强临床医生对该病的认识。方法选取黑龙江省农垦总局总医院2017年收治的474例布病患者的流行病学和临床资料进行回顾性分析。结果布病一年四季均可发病,以4—6月份为发病高峰(198例,41.77%);男女性别比约为4∶1,发病年龄以19~50岁为主(325例,68.57%),420例患者(88.61%)有明确牛、羊接触史。临床表现主要有发热(421例,88.82%)、多汗(378例,79.75%)、乏力(398例,83.97%)及关节痛(364例,76.79%)等。误诊为上呼吸道感染者396例,关节疼痛表现误诊为关节炎、脊柱结核等也较多见。治愈随访,除14例偶有关节疼痛发生外,其余病例均无复发。结论布病易感人群多数有明确接触史,临床表现常不典型,诊断应注意询问接触史,并借助辅助检查手段以减少误诊。

Objective To understand the epidemiological and clinical characteristics of brucellosis, and to further strengthen the understanding of brucellosis in clinical doctors. Methods The clinical data of 474 brucellosis patients in Heilongjiang Provincial General Administration of Reclamation and Reclamation in 2017 were retrospectively analyzed and summarized. Results Brucellosis could occur in all seasons of the year, with the peak incidence from April to June (198 cases, 41.77%). The male to female ratio was about 4∶1, and the age of onset was mainly 19-50 years old (325 cases, 68.57%). The main source of infection was sheep and cattle (420 cases, 88.61%). The main clinical manifestations were fever (421 cases, 88.82%), hyperhidrosis (378 cases, 79.75%), fatigue (398 cases, 83.97%) and arthralgia (364 cases, 76.79%). There were 396 cases misdiagnosed as upper respiratory tract infection, and some patients who had arthralgia were commonly misdiagnosed as arthritis and spinal tuberculosis. After several months’ follow-up, except for 14 cases of occasional joint pain, the rest cases were stable and had no recurrence. Conclusions Most brucellosis patients have clear contact history, and the clinical manifestation is atypical. Therefore, more attention should be paid to the contact history and supplementary way should be used for reducing misdiagnosis.