2～14岁赴美移民申请人结核病筛查结果分析  

Analysis on the Results of Tuberculosis Screening among the USA Immigrating Applicants of 2～14 Years Old

作　　者：张建明[1] 何洪涛[1] 黄立萍[1] 王舜钦[2] 雷兆良[1] 黄永欣[1] 王向阳[1] 冯心文[1] 张敏[1] 

机构地区：[1]广东国际旅行卫生保健中心,广州510635 [2]厦门市卫生局,厦门361003

出　　处：《中国国境卫生检疫杂志》2010年第5期300-303,共4页Chinese Journal of Frontier Health and Quarantine

摘　　要：[目的]对2-14岁赴美移民申请人结核病筛查的结果进行分析,为早期发现潜伏结核感染、肺结核患者及结核病防控提供参考依据。[方法]对2009年7月—2010年3月期间在广东国际旅行卫生保健中心体检的2747名2-14岁赴美移民申请人进行结核病筛查,所有申请人均进行结核菌素皮试（TST）;若TST≥10mm或申请人有疑似结核的体征或症状,应进行X线胸片检查;若胸片所见疑似结核或有疑似结核的体征或症状的,进行结核分枝杆菌实验室检测。[结果]TST皮试结果显示阳性率为47.40%,阴性率52.60%,其中中度阳性者624名,占总人数的22.72%,强阳性者25名,占总人数的0.91%。阴性率随年龄增长逐渐下降,阳性与中度阳性率随年龄增长逐渐上升（P〈0.001）。649名TST≥10 mm者胸片检查结果发现,疑似结核病患者8人,其中非领养儿童1例,领养儿童7例。结核分枝杆菌实验室检测结果发现,8例疑似肺结核患者中,1例为耐多药结核患者。[结论]加强儿童,特别是生活条件和营养条件差的儿童结核病的筛查,提高卡介苗覆盖率及接种质量对于儿童肺结核的防控具有重要意义。Objective To provide references for early latent tuberculosis infection（LTBI）,tuberculosis detection and TB control and prevention by analysing the results of tuberculosis screening conducted on 2-14 years old immigrating applicants to USA.Methods TST was conducted among 2 747 immigrating applicants of 2-14 years old to USA in Guangdong International Tranel Health Care Center from July 2009 to March 2010.If the result of TST was ≥ 10 mm,or if it suggests the applicant symptoms or signs of TB,chest radiography（CXR） should be performed.And applicants with symptoms,signs or CXR suggestive of TB,sputum specimens should be collected to undergo microscopy for acid-fast bacilli（AFB）,as well as culture for mycobacteria and confirmation of the Mycobacterium species.Results The positive rate and the negative rate of TST results were 47.40% and 52.60%,respectively.A total of 624 cases were moderately positive（＋＋）,accounting for 22.72%;25 cases were strong positive（＋＋＋）,accounting for 0.91%.Negative rate of TST decreased gradually with age.Positive and moderately positive rate of TST increased gradually with age（P〈0.001）.The chest examination found 8 suspected TB patients,including 1 case of non-adopted child and 7 cases of adopted children.Among 8 suspecpted TB patients,there was one case of MDR-TB patient in laboratory test of Mycobacterium tuberculosis.Conclusion It is important to conduct the screening of TB upon children,especially those live in poor conditions and malnutrition,and increase BCG vaccination coverage for the prevention and control of TB within children.

关 键 词：结核菌素试验 潜伏结核 结核 儿童 领养儿童 移民 筛查 

分 类 号：R446.61[医药卫生—诊断学]