目的通过布鲁菌病流行病学特征,提高临床和实验室的诊断能力。方法回顾性分析2013年1月至2015年6月收治的布鲁菌病患者的临床资料、实验室数据。结果 39例病例大多有羊接触史,临床主要表现为发热(100.0%)、骨关节疼痛(64.1%)、多汗(51.3%)、乏力(33.3%)、淋巴结肿大(23.1%)、肝脾肿大(12.8%)。实验室检查,有肝功能异常、红细胞沉降率增快、超敏C-反应蛋白增高、淋巴细胞比例增高,布鲁菌抗体凝集试验阳性,静脉血或骨髓培养阳性,经细菌学鉴定为马耳他布鲁菌。结论布鲁菌病临床表现多样,易误诊,苏北地区散发病例逐年增多,应重视流行病学线索,加强对布鲁菌病的认识,对不明原因发热者应及早进行血培养和布鲁菌凝集试验。
Objective To analyze the epidemiological characteristics of brucellosis for improving its clinical and laboratory diagnostic ability.Methods The clinical and laboratorial data of the patients with brucellosis in our hospital from January 2013 to September 2015 were retrospectively analyzed.Results In 39 cases of brucellosis,the majority had the sheep-contacting history and the clinical manifestations were mainly fever(100.0%),bone and joint pain(64.1%),hidrosis(51.3%),weak(33.3%),lymph node enlargement(23.1%)and hepatosplenomegaly(12.8%).The laboratory detections showed the abnormal liver function,rapid erythrocyte sedimentation rate(ESR),hypersensitive C-reactive protein(hs-CRP)increase,lymphocytes percentage increase,positive for brucellosis antibody agglutination test,positive blood culture or medulloculture,which was identified as Brucella melitensis by bacteriology.Conclusion The clinical manifestations of brucellosis are diversity and is easy to be misdiagnosed.The sporadic cases in northern Jiangsu area are increased year by year.The epidemiological clue should be paid attention to and the recognition on brucellosis should be strengthened.The patients with fever of undetermined origin should be conducted the blood culture and brucellosis antibody agglutination test as early as possible.