结核病专业人员及密切接触者结核潜伏感染的研究  

Investigation of latent Mycobacterium tuberculosisinfection in tuberculosis professionals and close contacts of TB patients

作　　者：张忠顺[1,2] 楼海[1,2] 肖和平[1,2] 

机构地区：[1]同济大学附属上海市肺科医院/上海市结核病(肺)重点实验室 [2]同济大学医学院,上海200433

出　　处：《中国防痨杂志》2011年第1期36-40,共5页Chinese Journal of Antituberculosis

基　　金：第五轮中国全球基金结核病项目TB08-006;国家科技重大专项2009ZX10004-714

摘　　要：目的利用γ-干扰素释放反应检测结核病专业人员及密切接触者结核分枝杆菌潜伏感染情况。方法研究对象共分3组:结核病专业人员组128例(其中医生60例,护士68例)、病人家属密切接触组60例、非密切接触组40例,应用T-SPOT.TB(Oxford Immunotec,Abingdon,UK)试剂盒检测外周静脉血淋巴细胞对于2种结核分枝杆菌菌种特异性分泌蛋白:早期分泌靶抗原6(ES-AT-6)和培养分泌蛋白10(CFP-10)的免疫反应。结果结核病专业人员组的阳性率为14.8%(19/128),家属密切接触组为23.3%(14/60),非密切接触组为5.0%(2/40)。家属密切接触组较健康对照组明显为高(χ2=6.002,P=0.023);结核病专业人员组与非密切接触组比较差异无统计学意义,但有不同程度的升高。工作年限≥3年的结核病专业人员组的阳性率27.1%(16/59)较非密切接触组5.0%(2/40)明显为高(χ2=7.840,P=0.007),其RR值为5.42(95%CI=1.32～22.31)。结论结核病专业人员及密切接触者受结核分枝杆菌潜伏感染的危险性高,且与接触时间成正比。Objective To study latent Mycobacterium tuberculosis infection in TB professionals and those who in close contact with TB patients by γ-interferon secretory reaction.Methods All subjects were divided into three groups： Group 1 included 128 TB professionals（60 physicians and 68 nurses）.Group 2 included 60 household close contacts of TB patients.Group 3 included 40 subjects without close contact with TB patients.T-SPOT.TB（Oxford Immunotec,Abingdon,UK） was used to assay the immune reactions of peripheral blood lymphocytes to two special secreted proteins of Mycobacterium tuberculosis： 6-kDa early secreted antigenic target（ESAT-6） and culture filtrate protein 10（CFP-10）.Results Positive rate in TB professionals,household close contacts and those who have no close contact with TB patients were 14.8%（19/128）,23.3%（14/60） and 5.0%（2/40） respectively.The positive rate of group 2 was significantly higher than that of group 3（χ2=6.002,P=0.023）.The positive rate of group 1 was higher than that of group 2 although the difference was not statistically significant.The positive rate of senior TB professionals who have worked for at least 3 years was 27.12%（16/59）,this was significantly higher than that（5.0%,2/40） of group 3[χ2=7.840,P=0.007;RR=5.42（95%CI=1.32~22.31）].Conclusion TB professionals and those who in close contact with TB patients are at higher risk of latent Mycobacterium tuberculosis infection and it has positive correlation with contact duration.

关 键 词：结核/传播 疾病传播 病人至卫生人员 免疫酶技术 干扰素Ⅱ型 

分 类 号：R52[医药卫生—内科学]