结核感染T淋巴细胞斑点试验筛查活动性肺结核病人密切接触者结果分析  

Analysis on the Results of T-SPOT. TB in Tuberculosis Contacts

作　　者：孟祥爱 赵静 王海英[2] 景辉[2] 邓云峰[2] 王俊玲[2] 汪运山[3] 宋光民[4] 

机构地区：[1]济南市第六人民医院,山东章丘250200 [2]山东省胸科医院,山东济南250013 [3]济南市中心医院,山东济南250013 [4]山东大学齐鲁医院,山东济南250012

出　　处：《预防医学论坛》2011年第1期3-5,共3页Preventive Medicine Tribune

基　　金：山东省科技攻关项目(2010GSF10246);济南市青年科技明星项目(12111);济南市企业自主创新项目(03119);济南市科学技术发展项目(18032)

摘　　要：[目的]探讨利用结核感染T淋巴细胞斑点试验（T-SPOT.TB试验）对学生中的潜伏结核感染者进行筛查的效果及其影响因素,为学校结核病预防和控制提供新的依据。[方法]2008年在山东某学院对1名患有活动性肺结核学生的同年级学生进行T-SPOT.TB试验、胸透和临床症状评估和流行病学调查。[结果]调查对899名学生进行胸透,4名异常（3人确诊为菌阴性肺结核,1人为结核性胸膜炎）。检测803人中,T-SPOT.TB试验阳性的73人,阳性率为9.09%。T-SPOT.TB试验阳性率,有、无卡介苗接种史者分别为8.77%、10.77%（P〉0.05）,男女生分别为9.69%、8.52%（P〉0.05）,有、无结核病接触史的分别为15.00%、8.80%（P〉0.05）;是、否常晒被褥的分别为7.43%、11.96%（P〈0.05）,是、否规律作息的分别为8.22%、66.67%（P〈0.01）,锻炼身体时间〉60、30~60、〈30 min/d的分别为7.44%、8.79%、32.26%（P〈0.01）,每日吸烟是、否〉5支的分别为6.67%、8.92%（P〉0.05）,心理压力较轻、一般、较重的分别为10.37%、8.24%、8.70%（P〉0.05）,性格乐观、悲观的分别为7.42%、14.29%（P〉0.05）,营养状况较好、一般、较差的分别为8.23%、9.61%、10.00%（P〉0.05）。[结论]T-SPOT.TB试验特异性较好,良好的生活方式有助于预防结核杆菌的感染。[Objective]To explore the screening effect of T-SPOT.TB test and its influencing factors among latent tuberculosis infection,and provide new evidence for prevention and control of tuberculosis in schools.[Methods]In 2008,when an active pulmonary tuberculosis patient with sputum TB（2＋） appeared in a certain college in Shandong province,students were screened who were the same grade with the case.The projects of screening included T-SPOT.TB test,clinical and radiographic assessment and epidemiological investigation.[Results]Among 803 students,T-SPOT.TB result was positive in 73 cases,the positive rate was 9.09 %.T-SPOT.TB result positive rate,BCG vaccination,8.77%,no BCG vaccination 10.77%（P0.05）;males,9.69%,females,8.52%（P0.05）;history of exposure to tuberculosis,15.00%,no history of exposure to tuberculosis 8.80%（P0.05）;drying the quilt,7.34%,no drying the quilt,11.96%（P 0.05）;regular schedule,8.22%,irregular schedule,66.67%（P0.01）;the time of exercise 60 min/d,7.44%,30-60 min/d,8.79%,30 min/d,32.26%（P0.01）;smoking5/d,6.67%,5/d,8.92%（P0.05）;The psychological pressure lighter 10.37%,general,8.24% heavier,8.70 %（P0.05）;optimistic,7.42%,pessimistic,14.29%（P0.05）;good nutrition,8.23%,general nutrition,9.61%,poor nutriation,10.00% 10（P 0.05）.[Conclusion]Specificity of T-SPOT.TB is higher,better lifestyle contribute to preventing the infection of Mycobacterium tuberculosis.

关 键 词：潜伏结核感染 结核感染T淋巴细胞斑点试验 接触者调查 

分 类 号：R521[医药卫生—内科学]