布鲁氏菌血流感染流行病学及临床特征

Epidemiological and clinical characteristics of Brucella bloodstream infections

  • 摘要: 目的 探究布鲁氏菌血流感染患者流行病学及临床特征,为临床医生对布鲁氏菌病的科学诊疗提供参考依据。方法 回顾性收集2022年10月-2024年10月山西医科大学第一医院收治的布鲁氏菌血流感染患者的临床资料,将患者分为青年组(16~44岁),中年组(45~59岁),老年组(≥60岁),分析三组患者的流行病学特征、临床表现以及实验室检查结果。结果 本研究共纳入65例患者,其中青年组18例,中年组27例,老年组20例。流行病学资料显示,三组患者接触史差异比较有统计学意义(P=0.022)。临床表现以发热(93.85%)、乏力(47.69%)多见,其中乏力、腰痛、肌肉痛、关节痛、脊柱炎的发生率三组差异比较有统计学意义(P= 0.027、0.033、0.024、0.028、0.008)。实验室检查结果中,三组患者碱性磷酸酶、白蛋白水平变化状态比较具有统计学意义(P=0.041,0.019)。分别有86.15%、95.38%患者嗜酸性粒细胞百分比、白蛋白降低。结论 中、老年布鲁氏菌血流感染患者乏力、腰痛、肌肉痛、关节痛、脊柱炎发生率高于青年患者,碱性磷酸酶、白蛋白实验室检查结果变化差异显著,提示临床医生可根据各年龄组患者临床特征的不同特点进行早期防治。

     

    Abstract: OBJECTIVE To explore the epidemiological and clinical characteristics of the patients with Brucella bloodstream infections so as to provide bases for scientific diagnosis and treatment of brucellosis. METHODS The clinical data were retrospectively collected from the patients with Brucella bloodstream infections who were treated in The First Hospital of Shanxi Medical University from Oct. 2022 to Oct. 2024. The patients were divided into the young group(age between 16 and 44 years old), the middle-aged group(aged between 45 and 59 years old) and the elderly group(aged no less than 60 years old). The epidemiological characteristics, clinical manifestations and result of clinical laboratory test were observed and compared among the three groups of patients. RESULTS A total of 65 patients were enrolled in the study, with the young group 18 cases, the middle-age group 27 cases, the elderly group 20 cases. The epidemiological data indicated that there was significant difference in the history of contact among the three groups of patients(P=0.022). The cliical manifestations were dominated by fever (93.85%) and fatigue(47.69%); there were significant difference in the indicence rates of fatigue, low back pain, muscle pain, joint pain and spondylitis among the three groups(P= 0.027, 0.033, 0.024, 0.028, 0.008). Ther result of clinical laboratory testing showed that there were significant differences in the levels of alkaline phosphatase and albumin among the three groups of patients(P=0.041,0.019). The patients with decresed percentage of eosinophils accounted for 86.15%, the patients with decreased level of albumin 95.38%. CONCLUSIONS The incidence rates of fatigue, low back pain, muscle pain, joint pain and spondylitis are higher among the middle-age and elderly patients with Brucella bloodstream infections than among the young patients. There are significant differences in the results of clinical laboratory tests for alkaline phosphatase and albumin, it is suggested that the clinicians should carry out the early prevention and treatment based on the clinical characteristics of the different age groups of patients.

     

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