布鲁杆菌病的临床特征分析

目的 探讨不同菌株感染所致的布鲁杆菌病(布病)急慢性期的临床表现及多系统损害规律,为布病的预防、临床诊断及深入研究提供依据. 方法 对2005-2007年采集自黑龙江省农垦总医院的1470例布病患者的临床资料进行分析,患者主要来自黑龙江省各大农场. 结果 (1)这些患者的感染菌株以牛种布鲁杆菌和羊种布鲁杆菌为主,分别占总数的39.93%和58.98%.(2)布病急性期患者共723例,多见发热(70.95%)、自汗(68.74%)、乏力(68.88%).慢性期患者共747例,患者乏力(71.08%)和骨关节系统损害(78.98%)较为明显.约1/3的患者均存在发热、自汗及包括消化、循环和生殖系统等多个系统损害.(3)牛种布鲁杆菌所致的布病患者乏力(84.84%)及关节损害(72.40%),明显多于羊种布鲁杆菌所致的布病患者. 结论 不同阶段、不同菌株所致布病的临床症状及系统损害有一定特征,有助于临床布病的诊断治疗.今后应加强菌株宿主转移后可能引起的菌株变异对新宿主器官不同部位选择性伤害的研究.

Analysis on the clinical character of brucellosis

Objective To investigate the clinical manifestations and multi-system damage of brucellosis caused by different strains during different stages, and to provide evidence for the clinical diagnosis, prevention and in-depth study. Methods The clinical data of 1470 cases of patients with brucellosis in general hospital of Heilongjiang Land Reclamation from 2005 to 2007 were analyzed. Mast of the patients came from the large farms in Heilongjiang province. Results (1) The mainly infectious strains of these cases were B. Abortus and B. Melitensis, accounted for 39.93% and 58.98% respectively. (2) There was a total of 723 cases with acute brucellosis, most of them had fever(70.95%), spontaneous perspiration(68.74%), fatigue(68.88%). There was a total of 747 cases with chronic brucellosis. Weakness (71.08%), bone and joint system damage(78.98%)were more obvious. About one third of the patients had fever,spontaneous perspiration and multi-system damage, including digestion, circulation and reproductive. (3)Weakness (84.84%), bone and joint damage(72.40%)in brucellosis caused by B. Abortus were more common than that caused by B. Melitensis. Conclusions There are some certain character in the symptoms and multi-system damage of brucellosis caused by different strains during different stages. The study on the selectivity damage in new host organs caused by strain variations due to the strain transformation should be strengthened.