Objective To investigate the immune status of patients with brucellic disease in non-pasturing area and high-risk factors of infection.Methods From January 2008 to November 2016,330 patients with brucellic disease in non-pasturing area received in Traditional Chinese Medicine Hospital of Langfang City were selected as the observation group,330 healthy personnel with the same occupation at the same time were selected as the control group.Then the serum immunoglobulin,circulating immune complex and T lymphocyte subsets of observation group with different treatment effect were compared.The consist of gender,ages,nationality,work types,length of job,hygienic habit and contact with livestock situation of two groups were compared,and the relationship between those factors and infection of brucellic disease were analyzed by multivariate conditional Logistic regression.Results In the observation group,the serum immunoglobulin and the T lymphocyte subsets of cured cases in patients with brucellic disease were all lower than those of effective and ineffective patients,and circulating immune complex were significantly lower than those of effective and ineffective patients,with statistically significant differences (P ＜ 0.05).The gender,age and ethnic composition of the two groups were not statistically significant (P ＞ 0.05).There were statistically significant differences between the two groups of workers,working age,hygienic habits and contact with livestock (P ＜ 0.05).The multivariate conditional Logistic regression showed that sales,length of job ＜ 1 year,not washing hands by rules,not disinfectant application by rules,not sterilize the workplace by rules,drinking raw milk,eating sick and dead livestock,treatment of dead lambs,contacting with borted livestock or deliver livestock were all risk factors of infection (P ＜ 0.05).Conclusion The immune status of patients with brucellic disease in non-pasturing area are worse,and the differences of patients with different prognosis are obvious,the work types,length of job,hygienic habit and contact with livestock situation are all the high-risk factors of infection,the monitoring and regulation of immune should be carried out according to the patients' condition,and the prevention and control measures should be worked out according to the high-risk factors.%目的 调查非牧区布氏杆菌病患者免疫状态及感染高危因素.方法 选取2008年1月～2016年11月廊坊市中医医院收治的330例非牧区布氏杆菌病患者作为观察组,同期330例相同职业健康者作为对照组.比较观察组中不同疗效患者的血清免疫球蛋白、循环免疫复合物及T淋巴细胞亚群.比较两组的性别、年龄、民族、工种、工龄、卫生习惯及接触牲畜情况者的构成,并采用多因素条件Logistic回归分析处理上述因素与布氏杆菌病感染的关系.结果 观察组中痊愈者的血清免疫球蛋白及T淋巴细胞亚群显著高于有效及无效患者,循环免疫复合物均低于有效及无效患者,差异有统计学意义(P＜0.05).两组性别、年龄及民族构成比较,差异无统计学意义(P＞0.05).两组工种、工龄、卫生习惯及接触牲畜情况比较,差异有统计学意义(P＜0.05).多因素条件Logistic回归分析显示,从事销售、工龄＜1年、未按规定饭前洗手、未按规定应用消毒液、未按规定消毒工作场所、饮用生奶、吃病死牲畜、处理病死羔羊、接触流产或接生牲畜因素均是感染的危险因素(P＜0.05).结论 非牧区布氏杆菌病患者免疫状态较差,且不同预后患者的差异明显,工种、工龄、卫生习惯及接触牲畜情况等是感染的高危因素,应根据患者情况进行免疫的监控与调节,针对高危因素进行防控措施的制订.
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