摘要
目的探讨不同年龄组布鲁氏菌血流感染患者临床特征,为临床医师采取针对性诊疗措施提供依据。方法收集2015年1月至2020年1月在承德医学院附属医院住院治疗的成年布鲁氏菌血流感染患者的人口学资料及一般情况(年龄、性别、职业、所在地、发病季节、传染源、临床分期),临床特征(主要临床症状和并发症)及实验室检查结果(常规及病原学检查),将患者按照世界卫生组织推荐的年龄分层标准分为青年组(18~44岁)、中年组(45~59岁)和老年组(≥60岁),进行不同年龄组间各指标的比较分析。结果共纳入75例患者,包括青年组15例(20.00%),中年组37例(49.33%),老年组23例(30.67%),其中男性61例(81.33%)、女性14例(18.67%),各年龄组性别比例比较差异有统计学意义(χ^(2)=7.28,P=0.021);患者职业以农民为主(64例,85.33%),92.00%(69/75)的患者来自农村;传染源主要为带菌的牛羊、被污染的食物(共39例,52.00%);发病季节以春夏为主(45例,60.00%);临床分期以急性期为主(66例,88.00%)。临床症状方面,青年组患者无腰痛症状,中年、老年组患者腰痛发生率分别为35.14%(13/37)、30.43%(7/23),3组间比较差异有统计学意义(χ^(2)=6.98,P=0.031)。并发症方面,青年组患者无并发脊柱炎情况,中年、老年组患者脊柱炎发生率分别为32.43%(12/37)、34.78%(8/23),3组间比较差异有统计学意义(χ^(2)=6.86,P=0.032)。常规实验室检查方面,各年龄组患者血液淋巴细胞比例、白蛋白水平比较,差异均有统计学意义(F=3.41、3.27,P=0.038、0.044)。病原学检查方面,各年龄组患者血培养阳性报警时间中位数比较差异有统计学意义(H=9.54,P=0.008),中年组最长(66.24 h),老年组最短(58.80 h)。结论不同年龄组布鲁氏菌血流感染患者临床特征不同,中老年患者易发生腰痛症状,同时并发脊柱炎。临床医师需注意患者自身特点,有针对性地进行诊疗。
Objective To study the clinical characteristics of patients with brucella bloodstream infection in different age groups,and provide a basis for clinicians to take targeted diagnosis and treatment measures.Methods Demographic data and general condition(age,sex,occupation,location,onset season,source of infection,clinical stage),clinical characteristics(main clinical symptoms and complications),and laboratory test results(routine and pathogenic tests)of adult patients with brucella bloodstream infection admitted to the Affiliated Hospital of Chengde Medical College from January 2015 to January 2020 were collected.According to the age stratification standards recommended by the World Health Organization,the patients were divided into a young group(18-44 years old),a middle-aged group(45-59 years old),and an elderly group(≥60 years old),and various indicators among different age groups were compared and analyzed.Results A total of 75 patients were included,including 15 cases(20.00%)in the young group,37 cases(49.33%)in the middle-aged group,and 23 cases(30.67%)in the elderly group.Among them,61 cases(81.33%)were males and 14 cases(18.67%)were females,with statistically significant differences in gender ratios among different age groups(χ^(2)=7.28,P=0.021).The majority of patients were farmers(64 cases,85.33%),and 92.00%(69/75)of the patients came from rural areas.The main sources of infection were infected cattle and sheep,and contaminated food(39 cases,52.00%).The main season of onset was spring and summer(45 cases,60.00%).The clinical staging was mainly in the acute phase(66 cases,88.00%).In terms of clinical symptoms,the young group of patients had no symptoms of low back pain,while the incidence rates of low back pain in the middle-aged and elderly groups were 35.14%(13/37)and 30.43%(7/23),respectively.There was a statistically significant difference between the three groups(χ^(2)=6.98,P=0.031).In terms of complications,there were no cases of concurrent spondylitis in the young group of patients.The incidence
作者
苏丽
曹亚文
刘耀敏
张国民
张建华
崔凤梅
Su Li;Cao Yawen;Liu Yaomin;Zhang Guomin;Zhang Jianhua;Cui Fengmei(Department of Infectious Diseases,Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of General Medicine,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)
出处
《中华地方病学杂志》
CAS
北大核心
2023年第11期922-928,共7页
Chinese Journal of Endemiology
基金
2018年承德市科学技术研究与发展计划项目(201801A054)。
关键词
布鲁氏菌属
血流感染
年龄
临床特征
实验室检查
Brucella
Bloodstream infection
Age
Clinical characteristics
Laboratory examination
