论文部分内容阅读
目的:了解山东省枣庄市急性期布鲁氏菌病（简称布病）患者的流行病学特征及临床表现，以提高对布病的认识。方法:回顾性分析2019年1月至2020年12月枣庄市立医院确诊的急性期布病患者的人口学特征、流行病学特征、临床表现、实验室检查结果。结果:确诊的71例急性期布病患者中，男性患者居多，男女比例为2.2 ∶ 1.0（49 ∶ 22），年龄为（53.23 ± 14.12）岁，主要集中在枣庄市峄城区（32.39%，23/71）；80.28%（57/71）有流行病学接触史；全年均有发病，主要集中在4 - 10月（76.06%，54/71）；主要症状有发热（100.00%，71/71），肌肉关节疼痛（80.28%，57/71），乏力（54.93%，39/71），多汗（39.44%，28/71），部分有肝脾肿大（18.31%，13/71）和睾丸炎（4.23%，3/71）等。实验室检查结果显示，白细胞降低占12.68%（9/71），红细胞减少占21.13%（15/ 71），血小板减少占8.45%（6/71），淋巴细胞百分比降低占12.68%（9/71），C-反应蛋白升高占67.61%（48/ 71），红细胞沉降率加快占50.70%（36/71），部分伴有丙氨酸氨基转移酶升高（50.70%，36/71）和天门冬氨酸氨基转移酶升高（42.25%，30/71），血培养阳性患者57例（80.28%）。结论:枣庄市急性期布病患者临床特征不典型，对有流行病学接触史的长期不明原因发热患者，特别是伴有肌肉关节疼痛、肝脾肿大和睾丸炎者，应进行布病筛查。“,”Objective:To analyze the epidemiological characteristics and clinical manifestations of patients with acute brucellosis in Zaozhuang City of Shandong Province, and to improve the understanding of brucellosis.Methods:The demographic characteristics, epidemiological characteristics, clinical manifestations and laboratory examination results of patients with acute brucellosis diagnosed in Zaozhuang Municipal Hospital from January 2019 to December 2020 were retrospectively analyzed.Results:Most of the 71 patients with acute brucellosis were male, with a male-to-female ratio of 2.2 ∶ 1.0 (49 ∶ 22) and an average age of (53.23 ± 14.12) years old, mainly in Yicheng District (32.39%, 23/71); 80.28% (57/71) of patients had a history of epidemiological contact; the disease occurred throughout the year, mainly from April to October (76.06%, 54/71); the main symptoms were fever (100.00%, 71/71), muscle and joint pain (80.28%, 57/71), fatigue (54.93%, 39/71), hyperhidrosis (39.44%, 28/71), hepatosplenomegaly (18.31%, 13/71) and orchitis (4.23%, 3/71), etc. Laboratory examination results showed that decreased white blood cells accounted for 12.68% (9/71), decreased red blood cells accounted for 21.13% (15/71), thrombocytopenia accounted for 8.45% (6/71), decreased lymphocyte percentage accounted for 12.68% (9/71), increased C-reactive protein accounted for 67.61% (48/71), and accelerated erythrocyte sedimentation rate accounted for 50.70% (36/71). Some patients were accompanied by elevated alanine aminotransferase (50.70%, 36/71) and aspartate aminotransferase (42.25%, 30/71), 57 patients (80.28%) with positive blood culture.Conclusions:The clinical manifestations of acute brucellosis are atypical in Zaozhuang City. Brucellosis screening should be carried out for patients with long-term unexplained fever and an epidemiological exposure history, especially those with muscle joint pain, hepatosplenomegaly and orchitis.