2020—2022年布鲁氏菌病血清学检查结果与流行病学调查分析

Analysis of Serology Test Results and Epidemiological Survey of Brucellosis,2020-2022

目的对银川市贺兰县人民医院筛查出的5668例布鲁氏菌病(简称布病)患者的血清学结果与流行病学进行调查分析,以了解本地区布病的流行情况,提高临床医师对该病的认知与诊治水平。方法统计2020年1月至2022年12月贺兰县人民医院确诊的布病患者的血清学检查结果进行分析,并追踪研究临床资料。结果2020年1月至2022年12月共筛查5668例,其中阳性患者963例,阴性患者4705例,发病率为16.99%。分析初诊963例临床病例资料。963例布病患者资料中,男性748例,占比77.67%,女性243例,占比25.23%,男性阳性患者比例明显高于女性,差异有统计学意义(P<0.05)。布病患者年龄集中在40~60岁,农民为主要患病群体,发病率为72.25%。布病高发季节为春季,3月份为发病最高峰。10岁及以下儿童占0.92%,不容忽视。963例患者中接触方式以接触羊史(84.21%)为主,其次为接触牛史(10.59%),同时接触羊和牛史(4.88%)和猪史(0.31%)。针对963例患者患病接触方式调查后显示,以饲养接触方式为主,其比例高达96.46%,其次为屠宰,所占比例为1.66%,放牧、屠宰、接生、收购或者加工皮毛、喝牛奶或者羊奶以及邻居养羊等接触方式所占比例则较少,均不足1%。963例阳性患者以急性期为主,所占比例为83.69%,其次为亚急性期,所占比例为10.59%,最后是慢性期,所占比例为5.71%。布病阳性患者以发热症状为主,共814例(84.53%),其次为关节痛621例(64.49%)、淋巴结肿大51例(5.30%)、肌肉酸痛491例(50.99%)。发热为布病的主要表现,其次为关节痛。结论布病的临床表现不典型,患者易被误诊,应引起临床医师的高度重视。针对本地区饲养户需要给予高度重视,更要加强对本地区的布病的健康教育,普及相关疾病的知识,提高高危人群的防控意识,从而控制布鲁菌病传播扩散。

Objective To investigate and analyze the serological results and epidemiology of 5668 patients with brucellosis screened from Helan County People's Hospital in Yinchuan in order to understand the prevalence of brucellosis in this area,to improve clinicians'cognition and diagnosis and treatment of the disease.Methods The serological examination results of patients with brucellosis diagnosed in Helan County People's Hospital from January 2020 to December 2022 were analyzed,and the clinical data were followed up.Results A total of 5668 people were screened from January 2020 to December 2022,of which 963 were positive and 4705 were negative,with an incidence of 16.99%.The clinical data of 963 newly diagnosed patients were analyzed.Among the 963 patients with brucellosis,748 were male,accounting for 77.67%,and 243 were female,accounting for 25.23%.The positive rate of male was significantly higher than that of female,there was statistical significance(P<0.05).The age of patients with brucellosis is concentrated in 40-60 years old,farmers are the main disease group,the incidence rate is 72.25%.The high incidence season of brucellosis is in spring,and the peak of brucellosis is in March,with the largest number of people diagnosed.Children aged 10 and under account for 0.92%,which can not be ignored.Among the 963 patients,the main mode of contact was the history of contact with sheep(84.21%),followed by the history of contact with cattle(10.59%),the history of simultaneous contact with sheep and cattle(4.88%)and the history of pig(0.31%).The investigation on the contact mode of 963 patients showed that the proportion of feeding contact was as high as 96.46%,followed by slaughtering,accounting for 1.66%.The proportion of contact methods such as grazing,slaughtering,delivery,purchasing or processing fur,drinking milk or sheep milk and neighbors raising sheep accounted for less than 1%.The 963 positive patients were mainly in acute phase,accounting for 83.69%,followed by subacute phase,accounting for 10.59%,and finally chronic phase,accounting for 5.71%.The main symptoms of brucellosis positive patients were fever,a total of 814 cases(84.53%),followed by arthralgia(621 cases,64.49%),enlarged lymph nodes(51 cases,5.30%),and finally muscle soreness(491 cases,50.99%).It can be seen that fever was the main manifestation of brucellosis,followed by joint pain.Conclusion The clinical manifestation of Brucella is not typical and the patients are easy to be misdiagnosed,which should be paid great attention by clinicians.In view of the needs of breeders in this area,it is necessary to strengthen the health education of brucellosis in this area,popularize the knowledge of related diseases,and improve the awareness of prevention and control of high-risk groups,so as to control the spread of brucellosis.