延边州70例布鲁氏菌病临床特点分析

doi:10. 20223 / j. cnki. 1000-8535. 2026. 01. 015

摘要/Abstract

摘要： 目的分析布鲁氏菌病的临床表现以及实验室检查结果中的关键特征,系统总结布鲁氏菌病的诊断流程和治疗策略。方法选择2013年11月—2023年11月在延边大学附属医院通过血清虎红平板凝集试验（RBT）及试管凝集试验（SAT）检测技术确诊的70名布鲁氏菌病住院病例,对患者的流行病学资料、临床表现特征以及常规实验室检查结果进行回顾性分析,进而总结临床特点。结果 70例布鲁氏菌病患者中,男性占84.29%,中位年龄45岁（IQR 35~58岁）;91.43%具有牛/羊接触史。急性期占92.86%,主要症状为发热（100%）、多汗（88.57%）、关节痛（84.29%）及肝脾肿大（55.71%）,90%为不规则热型。误诊率27.14%,多误诊为败血症或骨关节疾病。联合抗菌药物治疗（利福平+多西环素）有效。结论延边州布鲁氏菌病非典型症状（如不规则热型）增加导致误诊率高。流行病学史（牛/羊接触史）是诊断关键。需强化对有牛羊接触史人群的防护意识及措施,提高临床对接触史线索和不规则热型等非典型表现的识别能力,规范治疗并控制传染源以遏制疫情。

关键词: 布鲁氏菌病, 流行环节, 临床特点

Abstract: Objective To analyze the clinical manifestations of brucellosis and the key characteristics in laboratory testing,and systematically summarize the diagnostic process and treatment strategies of brucellosis. Methods The 70 patients with brucellosis diagnosed via rose bengal test（RBT）and standard agglutination test（SAT） were at Yanbian University Affiliated Hospital from November 2013 to November 2023.This study conducted a retrospective analysis of the epidemiological data,clinical manifestations and routine laboratory pathological examination data of these patients,and the characteristics of clinical changes were summarized. Results Among the 70 patients with brucellosis,84.29% were male,with a median age of 45（IQR 35-58）;91.43% patients had a history of cattle/sheep exposure.The acute phase accounted for 92.86%,and the main symptoms were fever（100%）, sweating（88.57%）, arthragia（84.29%）, hepatosplenomegaly（55.71%）, and 90% were irregular fever. The misdiagnosis rate was 27.14%, and most of them were misdiagnosed as sepsis or osteoarthritis. Combined treatment with antibiotics（rifampin + doxycycline）was effective. Conclusions The increase in atypical symptoms（such as irregular heat type）leads to a high misdiagnosis rate.Epidemiological history（cattle/sheep contact）is the key to diagnosis.It is necessary to strengthen occupational protection and atypical case identification,standardize treatment and control the source of infection to curb the epidemic.

Key words: brucellosis, epidemic link, clinical characteristics

范月航, 邹天, 李欢欢, 陈宁. 延边州70例布鲁氏菌病临床特点分析[J]. 广州医药, 2026, 57(1): 100-104.

FAN Yuehang, ZOU Tian, LI Huanhuan, CHEN Ning. Clinical characteristics of 70 cases of brucellosis in Yanbian Prefecture[J]. Guangzhou Medical Journal, 2026, 57(1): 100-104.

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