布鲁菌性附睾睾丸炎患者临床特征分析

Clinical characteristics of Brucella epididym-orchitis

目的了解布鲁菌性附睾睾丸炎(BEO)患者临床特征。方法收集2017年9月至2019年10月呼伦贝尔市人民医院确诊收治的已婚男性急性期布鲁菌病患者的病历资料,分为BEO组和非BEO组,分别为46、50例,对其临床表现、实验室检查以及治疗效果进行分析评价。结果临床表现中,BEO组患者出现下腹痛、勃起功能障碍、早泄症状频率高于非BEO组[26.1%(12/46)比8.0%(4/50),89.1%(41/46)比12.0%(6/50),28.3%(13/46)比6.0%(3/50),χ^(2)=5.643、57.037、8.548,P均<0.05]。实验室检查中,BEO组患者白细胞(WBC)升高检出率高于非BEO组[23.9%(11/46)比8.0%(4/50),χ^(2)=4.602,P<0.05];精子浓度(DENS)降低检出率高于非BEO组[21.7%(10/46)比2.0%(1/50),χ^(2)=9.201,P<0.05]。治疗2~7 d,所有BEO患者阴囊肿痛和/或触痛减轻;治疗3~5 d,下腹痛、排尿困难症状减轻;治疗12周后,97.8%(45/46)的BEO患者阴囊睾丸彩超检查正常,95.1%(39/41)的勃起功能障碍者恢复正常,76.9%(10/13)的早泄患者症状消失,80.0%(8/10)的DENS降低者恢复正常,6例精子总活力(PRNPPER)降低患者中有5例恢复正常。结论BEO患者具有下腹痛、勃起功能障碍、早泄、生精功能障碍等临床特征,治疗后总体预后良好。

Objective To understand the clinical characteristics of Brucella epididym-orchitis(BEO).Methods The clinical data of married male patients with brucellosis in acute stage admitted to Hulunbuir People's Hospital from September 2017 to October 2019 were collected and divided into BEO group and non-BEO group,with 46 and 50 cases,respectively.The clinical manifestations,laboratory examination and treatment effect were analyzed and evaluated.Results The frequency of lower abdominal pain,erectile dysfunction and premature ejaculation in BEO group were higher than those in non-BEO group[26.1%(12/46)vs 8.0%(4/50),89.1%(41/46)vs 12.0%(6/50),and 28.3%(13/46)vs 6.0%(3/50),χ^(2)=5.643,57.037,8.548,P<0.05].In laboratory examination,the incidence of increased leukocyte(WBC)count in BEO group was significantly higher than that in non-BEO group[23.9%(11/46)vs 8.0%(4/50),χ^(2)=4.602,P<0.05].In terms of sperm function,the incidence of decreased sperm dens(DENS)in BEO group was significantly higher than that in non-BEO group[21.7%(10/46)vs 2.0%(1/50),χ^(2)=9.201,P<0.05].After 2-7 d of treatment,the pain and/or tenderness of scrotum were relieved in all patients with BEO.After 3-5 d of treatment,the symptoms of BEO patients with lower abdominal pain and dysuria were relieved.After 12 weeks of treatment,97.8%(45/46)of BEO patients had normal scrotal and testicular ultrasonography;95.1%(39/41)of BEO patients had normal erectile function,76.9%(10/13)of BEO patients had no premature ejaculation,and DENS returned to normal in 80.0%(8/10)of patients with DENS decreased.Five cases'sperm motility(PRNPPER)returned to normal of 6 patients with PRNPPER decreased.Conclusion BEO patients have the clinical characteristics of lower abdominal pain,erectile dysfunction,premature ejaculation and spermatogenic dysfunction,and the overall prognosis is good after treatment.