不同年龄段人群布鲁氏菌病急性期临床特征分析
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摘要
目的探讨不同年龄组布鲁氏菌病(布病)患者急性期临床特点。方法回顾性分析246例布病急性期住院患者的临床资料,按年龄分为婴幼儿组、学龄前组、青少年组、青年组、中老年组共5组。结果不同年龄组布病患者的急性期临床特点存在差异,在临床症状体征中乏力(P=0.015)、多汗(P=0.048)、腰痛(P<0.001)、肝脾肿大(P=0.013)等方面存在差异;在实验室检查中白细胞(P=0.001)、中性粒细胞百分比(P<0.001)、淋巴细胞计数(P<0.001)、谷丙转氨酶(P=0.024)、谷草转氨酶(P<0.001)、白蛋白(P<0.001)、C反应蛋白(P<0.001)、红细胞沉降率(P<0.001)等指标差异有统计学意义。其中,儿童患者发生乏力和多汗较成年患者少,更易发生肝功能损害出现肝脾肿大,而累及脊椎。临床表现为腰痛者以中老年患者最多,中老年患者组C反应蛋白和动态红细胞沉降率升高的发生率高于低年龄组。结论不同年龄组布病患者有不同的临床差异性,临床诊治中需要注意其特点。
Objective To investigate the clinical characteristics of brucellosis in acute phase in different age groups.Methods The clinical data of 246 hospitalized brucellosis patients were retrospectively analyzed. The patients were divided into 5 groups: infant group(age 0–3 years), preschool group(age 3–7 years), adolescent group(age 7–18 years), young adult group(age 18–45 years) and middle age and elderly adult group(age 45–77 years). Results The differences in fatigue(P=0.015), hidrosis(P=0.048), lower back pain(P<0.001) and hepatosplenomegaly(P=0.013) among the acute brucellosis patients in different age groups were significant. The laboratory test results of white blood cell count(P=0.001), neutrophil percentage(P<0.001), lymphocyte count(P<0.001), serum alanine transaminase(P=0.024), aspartate aminotransferase(P<0.001), ALB(P<0.001), C-reactive protein(P<0.001) and erythrocyte sedimentation rate(P<0.001) also showed significant differences among the acute brucellosis patients in different age groups. Less children showed fatigue and hidrosis compared with the adults, but they were more susceptible to liver function damage and hepatosplenomegaly. While lower back pain mainly occurred in middle age and elderly adults, and C-reactive protein and erythrocyte sedimentation rate increased with age. Conclusion The clinical characteristics of acute brucellosis patients varied in different age groups. These characteristics should be taken into account in clinical diagnosis of brucellosis.
Objective To investigate the clinical characteristics of brucellosis in acute phase in different age groups.Methods The clinical data of 246 hospitalized brucellosis patients were retrospectively analyzed. The patients were divided into 5 groups: infant group(age 0–3 years), preschool group(age 3–7 years), adolescent group(age 7–18 years), young adult group(age 18–45 years) and middle age and elderly adult group(age 45–77 years). Results The differences in fatigue(P=0.015), hidrosis(P=0.048), lower back pain(P<0.001) and hepatosplenomegaly(P=0.013) among the acute brucellosis patients in different age groups were significant. The laboratory test results of white blood cell count(P=0.001), neutrophil percentage(P<0.001), lymphocyte count(P<0.001), serum alanine transaminase(P=0.024), aspartate aminotransferase(P<0.001), ALB(P<0.001), C-reactive protein(P<0.001) and erythrocyte sedimentation rate(P<0.001) also showed significant differences among the acute brucellosis patients in different age groups. Less children showed fatigue and hidrosis compared with the adults, but they were more susceptible to liver function damage and hepatosplenomegaly. While lower back pain mainly occurred in middle age and elderly adults, and C-reactive protein and erythrocyte sedimentation rate increased with age. Conclusion The clinical characteristics of acute brucellosis patients varied in different age groups. These characteristics should be taken into account in clinical diagnosis of brucellosis.
引文
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[8]Turan H, Serefhanoglu K, Karadeli E, et al. Osteoarticular involvement among 202 brucellosis cases identified in Central Anatolia Region of Turkey[J].Intern Med, 2011,50(5):421–428. DOI:10.2169/internalmedicine.50.4700.
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[11]Bouley AJ, Biggs HM, Stoddard RA, et al. Brucellosis among hospitalized febrile patients in northern T nia[J]. Am J Trop Med Hyg, 2012,87(6):1105–1111. DOI:10.4269/ajtmh.2012.12–0327.
[12]Kokoglu OF, Hosoglu S, Geyik MF, et al. Clinical and laboratory features of brucellosis in two university hospitals in southeast Turkey[J]. Trop Doct, 2006,36(1):49–51. DOI:10.1258/004947506775598752.
[2]Katafiasz AR, Bartett P. Motivation for unpasteurized milk consumption in Michigan, 2011[J]. Food Protect Trends, 2012,32(3):124–128.
[3]杨绍基,任红.传染病学[M]. 7版.北京:人民卫生出版社, 2008:179–182.Yang SJ, Ren H. Lemology[M]. 7th ed. Beijing:People's Medical Publishing House, 2008:179–182.
[4]中华人民共和国卫生部.布鲁氏菌病诊疗指南(试行)[J].传染病信息,2012,25(6):323–324, 359. DOI:10.3969/j.issn.1007–8134.2012.06.002.The Ministry of Health of the People's Republic of China.Guidelines for the diagnosis and treatment of brucellosis(Trial)[J].Inf Infect Dis, 2012,25(6):323–324, 359. DOI:10.3969/j.issn.1007–8134.2012.06.002.
[5]Godfroid J, Scholz HC, Barbier T, et al. Brucellosis at the animal/ecosystem/human interface at the beginning of the 21st century[J].Prev Vet Med, 2011,102(2):118–131. DOI:10.1016/j.prevetmed.2011.04.007.
[6]诸福棠.实用儿科学(上册)[M].北京:人民卫生出版社,2015:1004–1006.Chu FT. Practical pediatrics, volume one[M]. Beijing:People's Medical Publishing House,2015:1004–1006.
[7]Kilic AU, Metan G, Alp E. Clinical presentations and diagnosis of brucellosis[J].Recent Pat Anti-Infect Drug Discovery, 2013,8(1):34–41. DOI:10.2174/1574891X11308010007.
[8]Turan H, Serefhanoglu K, Karadeli E, et al. Osteoarticular involvement among 202 brucellosis cases identified in Central Anatolia Region of Turkey[J].Intern Med, 2011,50(5):421–428. DOI:10.2169/internalmedicine.50.4700.
[9]Aziz S, Al-Anazi AR, Al-Aska AI. A review of gastrointestinal manifestations of Brucellosis[J].Saudi J Gastroenterol, 2005,11(1):20–27.
[10]Young EJ. Brucella species[M]//Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infec-tious Diseases. 7thed.Philadelphia:Churchill Livingstone, 2010:2921–2925.
[11]Bouley AJ, Biggs HM, Stoddard RA, et al. Brucellosis among hospitalized febrile patients in northern T nia[J]. Am J Trop Med Hyg, 2012,87(6):1105–1111. DOI:10.4269/ajtmh.2012.12–0327.
[12]Kokoglu OF, Hosoglu S, Geyik MF, et al. Clinical and laboratory features of brucellosis in two university hospitals in southeast Turkey[J]. Trop Doct, 2006,36(1):49–51. DOI:10.1258/004947506775598752.