【摘要】 目的 探讨儿童布鲁氏菌性关节炎的临床特点，提高临床医师对该病的认识，以提高早期诊疗水平。方法 收集2013年11月至2022年2月在郑州大学第一附属医院住院治疗的38例布鲁氏菌病患儿的临床资料，发现合并关节痛症状的患儿20例(52.63%),对20例患儿流行病学特点、临床表现、实验室检查、影像学检查及治疗进行回顾性分析。结果 20例患儿中，男孩16例(80%),女孩4例(20%),18例(90%)来自农村，2例(10%)来自城市。13例(65%)患儿有羊接触史或饮生羊奶、食羊肉史，7例(35%)患儿接触史不详。春夏季为发病高峰期。20例(100%)患儿均有发热及膝关节或髋关节等大关节疼痛，13例行布鲁氏菌凝集试验，均阳性，阳性率100.00%;14例行血培养，阳性11例，血培养阳性率78.57%;7例行骨髓培养，阳性6例，骨髓培养阳性率85.71%。12例行关节磁共振成像(MRI)检查，磁共振影像以关节积液、软组织肿胀、骨髓水肿、骨骼炎性改变为主。利福平联合多西环素或复方磺胺甲噁唑治疗有效。结论 儿童布鲁氏菌性关节炎以发热、关节痛为主要表现，主要累及膝关节或髋关节等大关节，临床表现不特异，详细询问牛羊接触史，及时行血培养、骨髓培养、布鲁氏菌抗体等检测可提高早期诊断率，避免误诊。更多还原

【Abstract】 Objective To investigate the clinical characteristics of brucella arthritis in children, in order to improve clinicians’ understanding of the disease and improve the level of early diagnosis and treatment.Methods The clinical data of 38 children with brucellosis admitted to our hospital from November 2013 to February 2022 were collected, and 20 children(52.63%) were found to have joint pain. The epidemiological characteristics, clinical manifestations, laboratory tests, imaging examinations and treatment of 20 children were retrospectively analyzed.Results Among the 20 children, 16 were boys(80%) and 4 were girls(20%). Eighteen children(90%) came from rural areas and 2 children(10%) came from urban areas. Thirteen children(65%) had a history of exposure to sheep or drinking raw goat milk or lamb meat, and 7 children(35%) had unknown exposure history. The peak of incidence was in spring and summer. All 20 cases(100%) had fever and pain in the knee or hip joint. 13 cases had Brucella agglutination test, and all were positive, with a positive rate of 100.00%. Blood culture was performed in 14 cases, and the positive rate was 78.57%. Bone marrow culture was performed in 7 cases, and the positive rate was 85.71%. Magnetic resonance imaging(MRI) was performed in 12 patients. MRI mainly showed joint effusion, soft tissue swelling, bone marrow edema, and bone inflammation. Rifampicin combined with doxycycline or compound sulfamethoxazole was effective.Conclusion Fever and arthralgia are the main manifestations of Brucella arthritis in children, which mainly involving the large joints such as the knee or hip joint. The clinical manifestations are not specific. Conducting a thorough investigation into the history of contact with cattle and sheep, promptly performing blood culture and bone marrow culture, as well as detecting Brucella antibody can enhance early diagnosis rate and prevent misdiagnosis.更多还原