布鲁氏菌病患者临床特征分析

发布时间：2018-03-05 11:15

本文选题：布鲁氏菌病　切入点：流行病学　出处：《中华医院感染学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的分析布鲁氏菌病患者临床特点,以提高对布鲁氏菌病的认识及诊断水平。方法回顾性分析2010-2012年医院诊断明确的21例布鲁氏菌病患者的流行病学、临床表现、实验室检查、治疗和转归,并进行文献复习。结果确诊为布鲁氏菌病的21例患者中,有明确不熟生肉或动物幼崽接触史者11例,占52.38%;有布鲁氏菌患者接触史1例,占4.76%;临床表现有发热、畏寒/寒颤、多汗、关节痛及乏力,其分布率分别为100.00%、57.14%、7.62%、38.10%、28.57%;实验室检查结果显示,血白细胞减少4例占19.05%、C-反应蛋白升高17例占80.95%、血细胞沉降率增快7例占33.33%;血培养阳性20例,阳性率为95.24%,骨髓培养阳性4例,阳性率为19.05%;随访该21例患者经内科积极治疗后均治愈。结论对长期不明原因发热者应结合流行病学特点考虑布鲁氏菌病可能,早期血培养和骨髓培养是有效的诊断手段;多西环素联合氨基糖苷类或利福平是有效的治疗手段。
[Abstract]:Objective to analyze the clinical features of patients with brucellosis and to improve the understanding and diagnosis of brucellosis. Methods Epidemiology, clinical manifestation and laboratory examination of 21 patients with brucellosis diagnosed in hospital from 2010 to 2012 were retrospectively analyzed. Results among the 21 patients diagnosed as brucellosis, 11 (52.38) had a history of contact with raw meat or animal cubs, and 1 (4.76%) had a history of brucellosis. The distribution rates of chills / chills, sweating, joint pain and fatigue were 100.00,57.14 and 7.62 respectively. Laboratory examination showed that 4 cases of leukopenia accounted for 19.05% of C- reactive protein increase in 17 cases (80.95%), 7 cases of rapid increase of blood cell sedimentation rate (33.3333%), 20 cases of positive blood culture. The positive rate was 95.24 and bone marrow culture was positive in 4 cases, and the positive rate was 19.05. All the 21 patients were cured after active medical treatment. Conclusion the possibility of brucellosis should be considered in patients with chronic fever of unknown origin according to the epidemiological characteristics. Early blood culture and bone marrow culture are effective diagnostic methods, and doxycycline combined with aminoglycosides or rifampicin are effective therapeutic methods.
【作者单位】：济宁医学院附属医院呼吸内科;济宁医学院附属医院神经外科监护室;济宁医学院附属医院检验科细菌室;
【基金】：山东省自然科学基金资助项目(ZR2012HL36)
【分类号】：R516.7

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