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| 4例神经型布鲁菌病的临床特点与诊治分析 |
| Clinical features, diagnosis and treatment of 4 cases of neurobrucellosis |
| 投稿时间：2025-01-03 修订日期：2025-01-03 |
| DOI： |
| 中文关键词: 神经型布病 临床表现 治疗 预后 |
| 英文关键词: Neuro-brucellosis Clinical features Treatment Prognosis |
| 基金项目:“十三五”国家科技重大专项项目, 中医药防治重大传染病脑炎脑膜炎症候群中西医结合诊疗预案及治疗方案的优化研究(2017ZX10305501005)；北京高层次公共卫生技术人才建设项目培养计划(学科骨干-02-31)。 |
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| 中文摘要: |
| 目的 为提高临床医生对神经型布病的诊治、改善患者预后，本文对4例神经型布病（neuro-brucellosis, NB）患者的临床资料进行报告。方法 收集并分析2024年1月-2024年9月在首都医科大学附属北京地坛医院确诊的4例NB患者的临床资料。结果 4例神经型布鲁菌病患者均有明确的流行病学史。临床多表现为脑膜炎、脊髓炎等。所有患者均行腰椎穿刺检查，3例患者脑脊液压力升高，4例白细胞数升高，4例患者蛋白升高，3例糖减低。所有患者血清布鲁杆菌凝集试验阳性，3例患者行脑脊液布鲁杆菌凝集试验阳性。4例患者给予在利福平和多西环素基础上组成的三联或四联抗布鲁菌治疗方案。结论 神经型布鲁氏菌病的临床表现复杂多样，早发现、早诊断利于患者预后，延误诊断的患者预后差，可留有后遗症。 |
| 英文摘要: |
| Objective To analyze the clinical data of 4 neuro-brucellosis (NB) patients，and provide basis for early diagnosis and treatment. Methods The clinical data of 4 patients with NB treated in Beijing Ditan Hospital, Capital Medical University from January 2024 to September 2024 were analyzed. Results All patients had certain contact history of cattle and sheep. Meningitis and myelitis were the main clinical manifestations. Lumbar puncture was performed in all patients, and cerebrospinal fluid (CSF) pressure was elevated in 3 patients. The leukocyte count and protein were increased in 4 patients and glucose reduced in 3 patients. The Brucella serum agglutination test of blood and CSF were positive in 4 and 3 patients, respectively. Four patients were treated with triple or quadruple anti-brucella regimens based on rifampicin and doxycycline. Conclusion The clinical manifestations of NB are complex and diverse. Early detection and diagnosis are conducive to the prognosis of patients. |
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