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目的总结布鲁菌病血培养阳性患者的临床特点,为布鲁菌病的诊治提供参考。方法收集布鲁菌病血培养阳性(血培养阳性组)和血培养阴性(血培养阴性组)患者的资料,从流行病学、临床特征、诊治方法等方面进行对比分析。结果牛羊养殖及密切接触是患者感染的重要途径。血培养阳性组以急性期患者多见,发热是最常见的症状,以高热为主。血培养阳性组有4例患者查见脾梗死,并发症的发生率高于血培养阴性组,心血管系统累及多见。血液学检查结果,血培养阳性组C-反应蛋白增高者58例(78.4%),明显多于血培养阴性组(50.7%)。血培养阳性的平均培养时间5.7d(3~12d),病原菌鉴定均为羊种布鲁菌,联合使用抗菌药物可获得较好预后。结论对于急性期伴有高热的布鲁菌病患者,全自动血培养系统可获得较高的血培养阳性率,临床和检验医师需提高对该菌的认识。
Abstract：Objective To summarize the laboratorial and clinical characteristics of patients infected with brucellosis whose blood was cultured with positive brucellosis,providing reference for the diagnosis and treatment of brucellosis.Methods Data regarding patients whose blood with both positive and negative culture of brucellosis was collected;Collected data of patients both in positive and negative blood culture group,comparison was performed from aspects of the epidemiology,clinical features,diagnosis and treatment.Results Closely contact and breeding with cattle and sheep were shown to be the primary way of infection.Acute phase was seen to be frequent in blood culture positive group.Fever was presented to be the main symptom with high degree.Spleen infarction was observed in four patients,the incidence of complications was seen to be significantly higher than that of the blood culture negative group,cardiovascular system was seen to be more frequently involved.In the case of outcome of blood test,elevated C-reactive protein(CRP)was detected in 58cases(78.4%)from blood culture positive group,which were significantly greater than that of blood culture negative group(50.7%).The mean incubation time of blood cul-ture positive was 5.7days(3~12days),brucella melitensis was the principally identified subspecies.Combination of antimicrobial agents can achieve better prognosis.Conclusion For patients infected with brucellosis in acute stage accompanied by high fever,automatic blood culture system has higher positive rate,clinicians and laboratory physicians need to improve the recognition of the bacteria.
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基本信息:
中图分类号:R516.7
引用信息:
[1]贾斌,张峰波,朱玥洁,等.血液检出布鲁氏菌阳性患者的实验室及临床特点分析[J].新疆医科大学学报,2017,40(02):136-140.
基金信息:
国家自然科学基金(81560322);; 新疆维吾尔自治区重点研发计划项目(2016B03047-1);; 新疆维吾尔自治区自然科学基金(2015211C100);; 新疆医科大学科研创新基金(XYDCX201507)
2017-02-15
2017-02-15