【摘要】 目的加强非牧区临床医生对布鲁杆菌病的认识,为早期诊断布鲁杆菌病,防止误诊提供依据。方法对广东省佛山市第一人民医院2011年1月至2015年10月收治的血培养为布鲁杆菌的52例住院病人的流行病学资料、临床症状、体征及实验室检查进行回顾性分析。结果病例感染途径主要为接触传播(71.15%),40~70岁年龄段患者占76.9%,职业分布前三位是退休或家务人员(23.08%)、饮食业(19.23%)、屠宰销售业(15.38%)。98%病例为急性期病人,临床表现主要有发热(92.30%)、关节痛(44.00%)、脾大(31.00%)、淋巴结肿大(23.08%)等。实验室检查腺苷脱氢酶升高者占84.62%,超敏C反应蛋白、降钙素原及血沉升高者分别占88.46%、82.69%、69.23%。结论非牧区城市的布鲁杆菌病例呈散发,临床表现复杂,累及多器官。临床医生需注意非畜牧业的人群发病,防止误诊。该病急性期患者治疗不规范,易致病情反复,迁延为慢性。更多还原

【Abstract】 Objective To improve the understanding of clinicians in non-pastoral areas to the disease of brucellosis,and provide data for early diagnosis and reducing misdiagnosis. Methods The epidemiological features,clinical symptoms,signs and laboratory examination of 52 cases of patients with brucellosis in the First People′s Hospital of Foshan from January 2011 to October 2015 were analyzed. Results Most of patients were infected by contact transmission(71.15%.). 76.9% patients were 40~70 years old of this group. Retiree or housework accounted for 23.08%,catering industry accounted for 19.23%,and butchery accounted for 15.38%.The main clinical manifestations were fever(92.30%),arthralgia(44.00%),splenomegaly(31.00%),lymphadenectasis(23.08%). Laboratory blood analysis indicated that 84.62% patients had adenosine deaminase increase,88.46% had hs CRP increase,82.69% had procalcitonin increase and 69.23% had erythrocyte sedimentation rate increased. Conclusion Brucellosis in non-pastoral areas were sporadic; the clinical symptoms were complicated,with multiple organ damaged. Clinicians need to paid attention to patients of non-graziery,to avoid misdiagnosis. The patients of brucellosis in acute stage without standardized treatment could easily lead to recurrent and persistent chronic disease.更多还原