关键词: 布鲁杆菌病, 流行病学, 临床特征, 疗效分析, 预后

Abstract: Background　Brucellosis belongs to the category B infectious disease which seriously endangers the public health safety in China's law on the prevention and control of infectious diseases.It has a high incidence rate，wide distribution，long duration and complex clinical manifestations.Therefore，the clinical diagnosis is difficult，the misdiagnosis rate，recurrence rate and disability rate are high，so it is necessary for clinicians to make early diagnosis and correctly select the type and course of antibiotics.Objective　To investigate epidemiology，clinical characteristics，laboratory examination，use of antibiotics，prognosis and recurrence in patients with brucellosis in Chengde，in order to provide guidance for the diagnosis and treatment of brucellosis.Methods　The demographic data，epidemiological data，clinical characteristics，laboratory results，treatment programs and prognosis of 340 patients suffering from brucellosis from the Third Hospital of Chengde from January 2010 to August 2018 were analyzed retrospectively.Meanwhile，100 blood samples of health examinees were collected during the same period.Results　Among the 340 cases，322（94.7%） had a definite history of contacting with infected sheep，and other 18（5.3%） had not.Higher rates of infecting with brucellosis were found in those raising cattle and sheep（59.2%），contacting with aborted or decreased cattle and sheep（20.5%），and engaging in slaughtering and fur processing（5.1%）.Main symptoms and signs included fever（81.5%），fatigue（71.5%），and joint pain，low back pain and leg pain（65.3%）.Compared with the control group，patients with brucellosis had lower mean white blood cell count，and neutrophil count and higher mean procalcitonin and C-reactive protein（P<0.05）.There are seven options that can be adopted for the treatment of brucellosis.Specifically，options 1，2，3，4，5，6，7 were used in 157，141，36，3，2，1，0，cases，respectively.The overall cure rate was 94.7%（322/340）.The cure rates for the used 6 options were 96.2%（151/157），95.0%（134/141），86.1%（31/36），100%，100%，100%，respectively.Option 1 achieved higher cure rate than option 3（χ2=4.92，P=0.026）.There were no significant difference in terms of cure rate between options 1 and 2（χ2=0.38，P=0.53），and between options 2 and 3（ χ2=3.09，P=0.08）.The adverse reactions of option 1 were liver injury〔5.1%（8/157）〕，gastrointestinal reactions 〔7.6%（12/157）〕 and agranulocytosis〔1.3%（2/157）〕.And those of option 2 were liver injury〔3.5%（5/141）〕，gastrointestinal reactions 〔4.3%（6/141）〕 and agranulocytosis〔0.7%（1/141）〕.Option 3 yielded adverse reactions such as liver injury〔5.6%（2/36）〕 and gastrointestinal reactions 〔8.3%（3/36）〕.Options 1，2，and 3 had no significant difference in the incidence of adverse reactions（χ2=2.22，P=0.14）.Conclusion　The diagnosis of brucellosis depends on epidemiological data（history of contacting with infected cattle and sheep and so on），complicated and diverse clinical manifestations，and specific laboratory examinations.However，due to lack of typical clinical features，involving various organ systems and yielding many complications，clinicians should increase their understanding of this disease.There are 7 therapeutic schemes for brucellosis，which can be selected according to the specific situation of patients.

Key words: Brucellosis, Epidemiology, Clinical characteristics, Analysis of curative effect, Prognosis