摘要目的 了解学龄前布鲁菌病(简称布病)患儿的流行病学和临床特点,以提高对儿童布病的认识及诊断水平.方法 收集2016年12月至2018年11月黑龙江省农垦总局总医院收治确诊的学龄前布病患儿的临床资料,回顾性分析患儿的流行病学特征、临床症状、实验室检查、治疗和转归情况.结果 共纳入45例学龄前布病患儿,其中男性29例,女性16例;年龄为(3.7±1.6)岁,范围为6个月 ～6岁,主要集中在>3～6岁(64.44％,29/45);居住地以农村为主(97.78％,44/45);发病时间主要集中在3-6月(46.67％,21/45).临床症状以发热、关节痛居多,分别占97.78％(44/45)、57.78％(26/45);淋巴结及肝脾肿大较多见,分别占42.22％(19/45)、35.56％(16/45).患儿治疗前、后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)及乳酸脱氢酶(LDH)比较,差异有统计学意义(t=4.774、2.970、2.229、5.664、5.805,P均<0.05).血标本培养布鲁菌阳性36例(80.00％,36/45),治疗后均转为阴性.结论 学龄前儿童布病流行病学和临床特点不典型.在布病流行区域及多发季节,对于不明原因发热的患儿,临床医生应详细询问其流行病史并结合临床特征,考虑布病的可能,争取早诊早治.

abstractsObjective To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis. Methods In - patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis. Results There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3 - 6 years old of age had the highest incidence (64.44％, 29/45). The patients were mainly rural residents (97.78％, 44/45). The onset time was mainly from March to June of the year (46.67％, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78％ (44/45) and 57.78％ (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22％ (19/45) and 35.56％ (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t = 4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00％, 36/45) had positive blood culture, which turned negative after the treatment. Conclusions The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.