The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications
The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications
复制标题
新疆590例布鲁氏菌病患者临床特点及重视并发症治疗
DOI：
10.1371/journal.pntd.0005577
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发表时间：
2017-05-01
影响因子：
3.8
通讯作者：
Ding, Jianbing
中科院分区：
文献类型：
--
作者：
Jia, Bin;Zhang, Fengbo;Ding, Jianbing
背景本研究旨在分析新疆地区590例布鲁氏菌病患者的临床特征和治疗结果。方法对590例布鲁氏菌病患者的临床特征、实验室检查、并发症及预后进行回顾性分析。患者平均年龄44.24 ± 15.83岁，60.5%有牛羊密切接触史。急性期占53.6%（316 /590），慢性期占21.5%。凝集试验阳性率为98.5%，血培养阳性率为34%。主要症状为乏力（91%）、多汗（88.1%）、发热（86.9%）、关节痛（81%），其中肝肿大占29.8%、脾肿大占26.1%、骨关节并发症占23.2%。多西环素联合利福平治疗12周是一种有效的治疗方案，无并发症。对于合并症的患者，建议采用3药方案（强力霉素+利福平+左氧氟沙星）治疗12周。死亡6例（1.02%），总复发率5.98%。结论新疆地区布鲁氏菌病主要与家畜生产接触有关。临床表现为发热、乏力、多汗、关节痛，常见的并发症为骨关节受累。多西环素+利福平+左氧氟沙星三联方案治疗12周有效。
Background This study aims to analyze the clinical characteristics and treatment outcomes of 590 patients with brucellosis in Xinjiang, China. Methodology and principal findings The clinical characteristics, laboratory findings, complications and prognosis of 590 patients infected with brucellosis were retrospectively analyzed. These patients had a mean age of 44.24 ± 15.83 years with 60.5% having a history of close contacting with cattle and sheep. Of them, 53.6% (316 /590) were in acute phase and 21.5% were in chronic phase. Agglutination test showed 98.5% positive with 34% blood culture positive of Brucella. The major symptoms were fatigue (91%), hyperhidrosis(88.1%), fever(86.9%), and joint pain(81%) with 29.8% having enlarged liver, 26.1% having enlarged spleen and 23.2% having osteoarticular complications. Combination of doxycycline plus rifampicin for 12 weeks was an effective regimen for patients without complications. The 3-drug regimen (doxycycline+rifampicin+levofloxacin) for 12 weeks was recommended for these with complications. There were 6 patients died (1.02%) with overall relapse rate of 5.98%. Conclusions Brucellosis is mostly associated with contacting with domestic animal production in Xinjiang, China. Clinical symptoms include fever, fatigue, hyperhidrosis, and joint pain with common complication of osteoarticular involvement. Three-drug-regimen of doxycycline+rifampicin+levofloxacin for 12 weeks was effective for these patients with complications.