Clinical Characteristics, Treatment, and Prognosis of Osteoarticular Brucellosis: A Retrospective Real-World Study in Shenyang, China, 2014-2019.

IF 17.7 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-04-12 DOI:10.1089/fpd.2023.0027

Dan Li, Guanmin Yuan, Yan O Wang, Hongyu Wang, Qiran Zhang, Yan Wang, Ye Gu, Haocheng Zhang, Yi Zhang, Jieyu Song, Zhangfan Fu, Ke Lin, Chao Qiu, Yang Zhou, Mingxiang Fan, Yuanhan Zhao, Jinxin Guo, Ning Jiang, Jingwen Ai, Hongyan Liu, Wenhong Zhang

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Abstract

This study aimed to assess the clinical characteristics, treatment, and prognosis of osteoarticular brucellosis. We conducted a retrospective study enrolling brucellosis patients from the Sixth People's Hospital of Shenyang between September 2014 and June 2019. A total of 1917 participants were admitted during this period. After applying propensity score matching, we retrospectively analyzed 429 patients with osteoarthritis and 429 patients without osteoarthritis. The primary outcome was treatment completion. The secondary outcome was symptom disappearance and seroconversion. Brucellosis patients with osteoarthritis had longer treatment course (160 [134.3-185.7] vs. 120 [102.3-137.7] d, p = 0.008) than those without osteoarthritis. The most common involved site was lumbar vertebrae (290 [67.6%]) in brucellosis patients with osteoarthritis. Longer symptom duration (90 [83.0-97.0] vs. 42 [40.2-43.8], p < 0.001) along with no significant difference in seroconversion (180 [178.8-181.2] vs. 180 [135.1-224.9], p = 0.212) was observed in osteoarthritis patients with treatment course >90 d. Peripheral joint involvement (adjusted hazard ratio [95% confidence interval] 1.485 [1.103-1.999]; p = 0.009) had a shorter symptom duration compared with shaft joint involvement. No significant differences were observed in treatment therapy between doxycycline plus rifampin (DR) or plus cephalosporins (DRC) in treatment course (p = 0.190), symptom persistence (p = 0.294), and seroconversion (p = 0.086). Lumbar vertebra was the most commonly involved site. Even if all symptoms disappeared, Serum agglutination test potentially remained positive in some patients. Compared with peripheral arthritis, shaft arthritis was the high-risk factor for longer symptom duration. The therapeutic effects were similar between DR and DRC. In summary, our study provided important insights into the clinical characteristics, treatment, and outcomes of osteoarticular brucellosis. Clinical Trial Registration number: NCT04020536.

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骨关节布鲁氏菌病的临床特征、治疗和预后：2014-2019年中国沈阳真实世界回顾性研究》。

本研究旨在评估骨关节布鲁氏菌病的临床特征、治疗和预后。我们在2014年9月至2019年6月期间对沈阳市第六人民医院的布鲁氏菌病患者进行了回顾性研究。在此期间，共有 1917 人入院。经过倾向评分匹配，我们对429名骨关节炎患者和429名非骨关节炎患者进行了回顾性分析。主要结果是完成治疗。次要结果是症状消失和血清转换。患有骨关节炎的布鲁氏菌病患者的疗程（160 [134.3-185.7] d vs. 120 [102.3-137.7] d，p = 0.008）比没有骨关节炎的患者长。在患有骨关节炎的布鲁氏菌病患者中，最常见的受累部位是腰椎（290 [67.6%]）。症状持续时间较长（90 [83.0-97.0] vs. 42 [40.2-43.8]，p 90 d）。与轴关节受累相比，外周关节受累（调整后危险比[95%置信区间] 1.485 [1.103-1.999]；p = 0.009）的症状持续时间较短。多西环素加利福平（DR）或加头孢菌素（DRC）的治疗方案在疗程（p = 0.190）、症状持续时间（p = 0.294）和血清转换（p = 0.086）方面均无明显差异。腰椎是最常受累的部位。即使所有症状都消失了，一些患者的血清凝集试验仍可能呈阳性。与外周关节炎相比，轴关节炎是症状持续时间较长的高危因素。DR和DRC的治疗效果相似。总之，我们的研究为了解骨关节布鲁氏菌病的临床特征、治疗和预后提供了重要依据。临床试验注册号：NCT04020536：NCT04020536。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.