北京市平谷区65例布鲁氏菌病患者临床特征分析

目的通过对北京市平谷区65例布鲁氏菌病患者流行病学调查,了解本区布鲁氏菌病疫情动态及患者临床特征,为疫情防控提供参考依据。方法选取2015年1月—2019年12月北京市平谷区医院收治的65例布鲁氏菌病患者作为研究对象,对发病时间、发病区域、年龄与性别构成、初步诊断、临床表现、病原学检查及诊治等情况进行统计与分析。结果患者年龄主要集中在18~59岁,性别比为4.42∶1;以畜牧饲养者居多,约占64.62%,有明确动物或动物制品接触史63例,占96.92%,均为散发,无明显聚集性;全年中以4—6月发病率最高,占发病总数的53.85%;临床症状以发热(52例,80.00%)、乏力(34例,52.31%)、腰痛(26例,40.00%)为主;其中并发症发生率为47.69%,排名较高的前3位分别是脊柱炎、关节炎、腰椎病变。65例患者首诊确诊49例,误诊16例,误诊率为24.62%。病原学检查结果显示,试管凝集试验阳性35例,虎红平板凝集试验阳性30例。结论布鲁氏菌病高发季节为4—6月,男性患病率明显高于女性,且从事畜牧业及相关产业人员为主要发病人群,以散发为主;布鲁氏菌病首诊误诊率较高,临床医师应提高对该传染病的关注,不断加强疫情防控。

Clinical characteristics analysis of 65 brucellosis patients in Pinggu District in Beijing

Objective To perform an epidemiological survey among 65 brucellosis patients in Pinggu District in Beijing,investigate the brucellosis epidemic situation and clinical characteristics in Pinggu District,and provide evidence for epidemic prevention and control.Methods Sixty-five patients with brucellosis in Beijing Pinggu Hospital from January 2015 to December 2019 were included in this study.The onset time,onset area,age and gender composition,primary diagnosis,clinical manifestations,etiological examination results and diagnosis and treatment were statistically analyzed.Results The patient’s age was mainly 18-59 years old,the gender ratio was 4.42:1.The patients were mostly livestock breeders,accounting for 64.62%.Sixty-five patients had a clear history of contact with animals or animal products,accounting for 96.92%.All patients with brucellosis were sporadic,without obvious clustering.The highest incidence was reported in April to June,accounting for 53.85%of the total.The main clinical symptoms included fever(52 cases,80.00%),fatigue(34 cases,52.31%),and low back pain(26 cases,40.00%).Among them,the complication incidence was 47.69%,the top 3 complications were spondylitis,arthritis,and lumbar spine lesions.Of 65 patients,49 cases were diagnosed in the first visit and 16 cases were misdiagnosed,the misdiagnosis rate was 24.62%.Etiological examination results showed that 35 patients were positive in the tube agglutination test 30 patients were positive in rose-bengal plate agglutination test.Conclusions The high incidence of brucellosis is from April to June.The prevalence rate of men is significantly higher than that of women.People engaged in animal husbandry and related industries are the susceptible population.The disease is mainly sporadic.The misdiagnosis rate in the first visit of brucellosis is relatively high.The clinicians should pay more attention on this infectious disease.The epidemic prevention and control should be strengthened.