布鲁氏菌病隐性感染者临床特征分析

Clinical characteristics of asymptomatic infection of brucellosis

目的分析布鲁氏菌病隐性感染者临床特征,以期为布鲁氏菌病防治提供参考依据。方法采用回顾性分析方法,收集联勤保障部队第九四〇医院于2017-2021年收治的布鲁氏菌病隐性感染者和确诊病例临床资料,分析其人口学特征、临床表现及实验室检查结果等。结果共纳入布鲁氏菌病隐性感染者18例、确诊病例85例,二者年龄,性别、职业、民族分布比较差异均无统计学意义(F=7.09,χ^(2)=0.74、4.02、0.55,P=0.295、0.785、0.327、1.000)。18例布鲁氏菌病隐性感染者均为重点人群筛查发现,且未出现临床症状和异常影像学征象;85例确诊病例临床症状以肌肉关节疼痛、发热、多汗、乏力、腰背痛为主,影像学表现以关节炎、脾肿大、脊椎炎为主。布鲁氏菌病隐性感染者与确诊病例嗜酸性粒细胞百分比(0.70%、1.40%)、嗜碱性粒细胞百分比(3.05%、0.40%)、C-反应蛋白(1.62、4.62 mg/L)、红细胞沉降率(1.00、11.00 mm/h)、血清凝集试验抗体效价中位数(1∶100、1∶200)比较,差异均有统计学意义(Z=-2.97、-5.11、-3.49、-3.21、-3.50,P=0.003、0.001、0.001、0.001、0.007)。结论布鲁氏菌病隐性感染者粒细胞构成与确诊病例存在差异,炎症反应指标水平低于确诊病例;重点人群定期开展血清流行病学调查有助于布鲁氏菌病隐性感染者筛查。

Objective To analyze the clinical characteristics of asymptomatic infection of brucellosis,in order to provide reference for prevention and treatment of brucellosis.Methods Retrospective analysis was used to collect the clinical data of patients with brucellosis asymptomatic infection and confirmed cases admitted to the 940th Hospital of Joint Logistics Support Force of Chinese PLA from 2017 to 2021,and the demography characteristics,clinical manifestations and laboratory test results were analyzed.Results The results showed that a total of 18 cases of asymptomatic infection and 85 confirmed cases of brucellosis were included,and there was no statistically significant difference in age,gender,occupation and ethnicity distribution between the two groups(F=7.09,χ^(2)=0.74,4.02,0.55,P=0.295,0.785,0.327,1.000).The 18 cases of asymptomatic infection of brucellosis were found through screening in key populations,and no clinical symptoms or abnormal imaging signs were observed.The clinical symptoms of 85 confirmed cases were mainly muscle and joint pain,fever,sweating,fatigue,and low back pain;and the imaging manifestations were mainly arthritis,splenomegaly,and spondylitis.The median percentage of eosinophils(0.70%,1.40%),percentage of basophils(3.05%,0.40%),C-reactive protein(1.62,4.62 mg/L),erythrocyte sedimentation rate(1.00,11.00 mm/h),and antibody titer of serum agglutination test(1∶100,1∶200)showed statistically significant differences between asymptomatic infection and confirmed cases of brucellosis(Z=-2.97,-5.11,-3.49,-3.21,-3.50,P=0.003,0.001,0.001,0.001,0.007).Conclusions There is a difference in the composition of granulocytes between asymptomatic infection and confirmed cases of brucellosis,and the level of inflammatory response indicators is lower than that of confirmed cases.Regular seroepidemiological surveys among key populations can help screen for asymptomatic infection of brucellosis.