摘要目的:了解以关节痛为首发症状的布鲁菌病患者的临床特点及诊疗思路，总结布鲁菌病合并关节痛的临床分型，为临床诊治提供参考。方法:选取2015年1月至2020年1月于中国人民解放军联勤保障部队第九四医院确诊的以关节痛为首发症状的布鲁菌病患者，分析其主要临床特征、实验室检查结果、诊治情况。结果:82例以关节痛为首发症状的患者中，男性61例、女性21例。患者以关节痛为主诉，就诊于脊柱外科的占63.4%（52/82），关节微创骨科的占17.1%（14/82），风湿免疫科的占12.2%（10/82），中医科的占7.3%（6/82）。布鲁菌病患者合并颈椎病变的占22.0%（18/82），合并腰椎病变的占51.2%（42/82）。患者C反应蛋白升高的占68.3%（56/82），肝功能异常的占52.4%（43/82），抗"O"阳性的占3.7%（3/82），自身抗体异常的占6.1%（5/82），人类白细胞抗原-B27（HLA-B27）阳性的占12.2%（10/82），HLA-B27阳性者中4例合并有骶髂关节炎。所有患者经规范足疗程治疗后均临床治愈。结论:布鲁菌病患者可能以关节痛为首发症状就诊，以腰椎和颈椎最易受累。

abstractsObjective:To understand the characteristics and diagnosis and treatment of brucellosis with joint pain as the first clinical manifestation, and summarize the clinical classification of brucellosis complicated with joint pain, so as to provide reference for clinical diagnosis and treatment.Methods:Cases of brucellosis with first symptom of joint pain diagnosed in the 940th Hospital of PLA Joint Logistic Support Force from January 2015 to January 2020 were selected. The main clinical features, laboratory examination, diagnosis and treatment were analyzed.Results:A total of 82 patients with joint pain of the first symptom were selected, including 61 males and 21 females. Joint pain was the main complaint of the patients, 63.4% (52/82) of the patients visited spine surgery department, 17.1% (14/82) visited minimally invasive orthopedics department, 12.2% (10/82) visited rheumatic immunology department, and 7.3% (6/82) visited traditional Chinese medicine department. Brucellosis patients with cervical lesions accounted for 22.0% (18/82), combined with lumbar lesions accounted for 51.2% (42/82). The patients with elevated C-reactive protein accounted for 68.3% (56/82), abnormal liver function accounted for 52.4% (43/82), anti "O" positive accounted for 3.7% (3/82), abnormal autoantibodies accounted for 6.1% (5/82), and human leukocyte antigen-B27 (HLA-B27) positive accounted for 12.2% (10/82). Four patients with HLA-B27 positive had sacroiliac arthritis. All patients were cured after standard and full course therapy.Conclusion:Joint pain may be the first symptom of brucellosis, and the lumbar spine and cervical spine are the most vulnerable parts.