Crosby E, Llosa L, Miro Quesada M, Carrillo C, Gotuzzo E
J Infect Dis. 1984 Sep;150(3):419-24. doi: 10.1093/infdis/150.3.419.
Hematologic abnormalities were studied prospectively in 38 patients with brucellosis. Anemia was found in 74% of patients, leukopenia in 45%, neutropenia in 21%, lymphopenia in 63%, and thrombocytopenia in 39.5%. Eight patients (21%) were pancytopenic; seven of these individuals also had splenomegaly. Bone marrow hypoplasia was not found. Bleeding complications developed in 26% of patients and were significantly associated with clotting abnormalities (low platelet count, low fibrinogen level, and/or prolongation of thrombin clotting time); i.e., bleeding occurred in approximately 50% of patients with marked clotting abnormalities but in no patients with normal clotting. Determination of fibrinogen levels at different stages of brucellosis led to a redefinition of the normal level for patients with this infection. Patients without clotting abnormalities had fibrinogen levels of 233-711 mg/100 ml (mean, 384 mg/100 ml), whereas patients with thrombocytopenia and prolonged thrombin clotting time had levels of 122-360 mg/100 ml (mean, 216 mg/100 ml; P less than .001) that increased to 233-519 mg/100 (mean, 360 mg/100 ml) when clotting values returned to normal. Lymphopenia was significantly correlated with the severity of clinical manifestations (bleeding and hepatic involvement).
对38例布鲁氏菌病患者的血液学异常进行了前瞻性研究。74%的患者出现贫血，45%出现白细胞减少，21%出现中性粒细胞减少，63%出现淋巴细胞减少，39.5%出现血小板减少。8例患者（21%）全血细胞减少；其中7例还伴有脾肿大。未发现骨髓发育不全。26%的患者出现出血并发症，且与凝血异常（血小板计数低、纤维蛋白原水平低和/或凝血酶凝血时间延长）显著相关；即，在凝血明显异常的患者中约50%出现出血，而凝血正常的患者均未出血。对布鲁氏菌病不同阶段纤维蛋白原水平的测定导致了对该感染患者正常水平的重新定义。无凝血异常的患者纤维蛋白原水平为233 - 711mg/100ml（平均384mg/100ml），而血小板减少且凝血酶凝血时间延长的患者纤维蛋白原水平为122 - 360mg/100ml（平均216mg/100ml；P <.001），当凝血值恢复正常时，该水平升至233 - 519mg/100（平均360mg/100ml）。淋巴细胞减少与临床表现（出血和肝脏受累）的严重程度显著相关。
