Objective To analyze the epidemiology and clinical characteristics of Brucella infection in Heilongjiang Province,and to provide experience and basis for clinical treatment and prevention of brucellosis.Methods Using retrospective analysis method,clinically diagnosed patients with brucellosis from December 2016 to December 2017 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms,laboratory examination results,diagnosis and treatment effect.Healthy subjects undergoing health check-up at the same period were randomly selected as control group for laboratory blood biochemical test.Results A total of 396 patients were included in the brucellosis group,including 298 males and 98 females,with an average age of (43.6 + 15.6) years old,ranged from 1 to 75 years old.The control group included 125 cases,including 83 males and 42 females,with an average age of (41.7 ±+ 18.0) years old,ranged from 7 to 71 years old.There were no significant differences in age and gender between the two groups (t =1.083,x2 =3.789,P ＞ 0.05).The patients of ＞ 14-64 years old of age had the highest incidence (90.15％,357/396).The patients were mainly rural residents (76.01％,301/396) and the majority of them were farms (50.51％,200/396).The onset time was mainly from March to June of the year (47.73％,189/396).Clinical symptoms were fever,joint or muscle pain and hyperhidrosis,which accounted for 91.16％ (361/396),76.26％ (302/396) and 44.19％ (175/396),respectively.The levels of C-reactive protein (CRP),seropropane alanine aminotransferase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptadase (γ-GT),alkaline phosphatase (ALP),α-hydroxybutyrate dehydrogenase (HBDH),and lactate dehydrogenase (LDH) in patients with brucellosis were significantly higher than those in the control group (t =4.956,2.746,4.019,3.272,7.008,3.728,3.409,P ＜ 0.01 or 0.05),while total protein (TP) and albumin (ALB) levels were reduced (t =-7.252,-8.601,P ＜ 0.01).After treatment,the test results of CRP,ALT,AST,γ-GT,TP,ALB,ALP,HBDH and LDH were compared with those before the treatment,and the differences were statistically significant (t =2.291,4.393,3.382,2.608,-7.516,-4.710,3.509,4.585,4.473,P ＜ 0.01 or 0.05).Conclusions The patients with brucellosis in Heilongjiang Province are mainly male farmers,and the onset time is mostly concentrated in March-June.The clinical manifestations of brucellosis are varied,clinicians should strengthen discrimination and prevent misdiagnosis.Medicines for brucellosis might be cautiously used in clinical trial,and changes in liver function and myocardial enzyme activity should be monitored.%目的 分析黑龙江省布鲁菌感染者的流行病学和临床特征,为布鲁菌病(简称布病)的预防和治疗提供经验和依据.方法 采用前瞻性设计,以2016年12月至2017年12月黑龙江省农垦总局总医院收治确诊为布病的住院患者为布病组,对其一般特征、临床特点、实验室检查、诊断及治疗效果等进行总结分析.同时选取同期本院的健康体检者作为对照组,进行实验室血生化检测.结果 布病组共纳入患者396例,其中男性298例、女性98例;年龄(43.6±15.6)岁,范围为1～ 75岁.对照组纳入125例,其中男性83例、女性42例;年龄为(41.7±18.0)岁,范围为7～71岁.两组人群年龄、性别间比较差异无统计学意义(t=1.083,x2=3.789,P均＞ 0.05).布病患者年龄集中在＞14～64岁(90.15％,357/396);居住地以农村为主(76.01％,301/396);职业分布以养殖户居多(50.51％,200/396);发病时间主要集中在3-6月(47.73％,189/396);临床症状以发热、关节肌肉痛、多汗居多,分别占91.16％(361/396)、76.26％(302/396)、44.19％(175/396).与对照组比较,布病组患者C-反应蛋白(CRP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰基转移酶(γ-GT)、碱性磷酸酶(ALP)、α-羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)均明显升高(t=4.956、2.746、4.019、3.272、7.008、3.728、3.409,P＜0.01或＜0.05),总蛋白(TP)、白蛋白(ALB)均降低(t=-7.252、-8.601,P均＜0.01).布病组治疗前、后CRP、ALT、AST、γ-GT、TP、ALB、ALP、HBDH及LDH比较,差异有统计学意义(t=2.291、4.393、3.382、2.608、-7.516,-4.710、3.509、4.585、4.473,p＜0.01或＜0.05).结论 黑龙江省布病患者以男性养殖户为主,发病时间多集中在3-6月份.布病临床表现多样,临床医生应加强辨别,防治误诊,并监测肝功能和心肌酶的变化,指导临床用药.
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