敦煌地区布鲁菌病患者的流行病学特征分析

Analysis of Epidemiological Characteristics of Patients with Brucellosis in Dunhuang Region

目的:分析敦煌地区布鲁菌病患者的流行病学特征,为该类患者的早诊断、早治疗提供参考。方法:选取2015年1月—2020年12月敦煌市医院收治的171例布鲁菌病患者作为研究对象,采集患者的性别、年龄、居住地、职业、发病时间、接触史、临床表现、实验室指标、并发症、最终转归等信息,分析其流行病学特点。结果:171例布鲁菌病患者中,其性别多为男性(132例,占77.19%),其年龄主要集中在40~<65岁(120例,占70.18%),其居住地多为农村(152例,占88.89%),其职业多为农牧民(145例,占84.80%),有128例(占74.85%)存在明确的牛羊接触史,其疾病分期多为急性(157例,占91.81%);171例患者中,最常见的症状为发热(158例,占92.40%)和关节痛(120例,占70.18%),其次为多汗(77例,占45.03%)、疲劳(66例,占38.60%)和脾肿大(58例,占33.92%),并发症则主要表现为关节炎(24例,占14.04%)和脊柱炎(22例,占12.87%);实验室检查结果显示,有不少患者出现转氨酶升高(99例,占57.89%)、α-羟丁酸脱氢酶(α-HBDH)升高(53例,占30.99%)、淋巴细胞增多(59例,占34.50%)、嗜酸性粒细胞减少(46例,占23.90%)、贫血(43例,占25.15%)等情况;后续随访显示,有132例患者完成了规范治疗,27例患者未完成规范治疗,有9例患者在治疗后6月内复发。结论:布鲁菌病的发生与人的生活环境、职业和牛羊接触史有着密切关系,发病后主要表现为发热和关节痛,临床在诊断时应注重对相关情况的了解,及早明确诊断,从而开展精准的治疗。

Objective:To analyze the epidemiological characteristics of patients with brucellosis in Dunhuang region,and provide reference for early diagnosis and treatment of such patients.Methods:171 patients with brucellosis admitted to the Hospital of Dunhuang City from January 2015 to December 2020 were selected as the research subjects,the information of the patients such as gender,age,place of residence,occupation,time of onset,history of exposure,clinical manifestations,laboratory indexes,complications and final outcomes was collected,and their epidemiological characteristics were analyzed.Results:Among the 171 patients with brucellosis,most of them were males(132 cases,77.19%),and their ages were mainly between 40 years old and lower than 65 years old(120 cases,70.18%);most of them lived in rural areas(152 cases,88.89%),most of them were farmers and herdsmen(145 cases,84.80%),and 128 cases(74.85%)had a definite history of exposure to cattle and sheep,and the staging of disease was mostly acute(157 cases,91.81%).Among the 171 patients,the most common symptoms were fever(158 cases,92.40%)and joint pain(120 cases,70.18%),followed by hyperhidrosis(77 cases,45.03%),fatigue(66 cases,38.60%)and splenomegaly(58 cases,33.92%),and complications were mainly arthritis(24 cases,14.04%)and spondylitis(22 cases,12.87%).Laboratory tests results showed that many patients had elevated transaminases(99 cases,57.89%),elevatedα-hydroxybutyrate dehydrogenase(α-HBDH)(53 cases,30.99%),increased lymphocytes(59 cases,34.50%),decreased eosinophils(46 cases,23.90%),anemia(43 cases,25.15%),etc.;the follow-up visits showed that 132 patients completed standard treatment,27 patients failed to complete the standard treatment,and 9 patients relapsed within 6 months after treatment.Conclusion:The occurrence of brucellosis is closely related to people's living environment,occupation,and history of exposure to cattle and sheep.After the onset,the main manifestations are fever and joint pain.Clinically,the relevant conditions of patients should be understood so as to make a definite diagnosis and carry out precise treatment.