上海地区四小学高年级学生结核感染率及影响因素的横断面研究  

Prevalence of latent tuberculosis infection and its risk factors among senior students from four primary schools in Shanghai

作　　者：林涛[1] 胡屹[2] 侯云[3] 蒋伟利[2] 陶韬[2] 马慧[2] 赵琦[2] 徐飚[2] 

机构地区：[1]上海市浦东新区疾病预防控制中心,200136 [2]复旦大学公共卫生学院教育部公共卫生安全重点实验室 [3]上海市杨浦区疾病预防控制中心

出　　处：《中华传染病杂志》2011年第3期148-153,共6页Chinese Journal of Infectious Diseases

基　　金：国家科技重大专项资助项目（2009ZX10003-017）

摘　　要：目的了解上海地区小学生潜伏结核感染的分布情况并分析影响儿童潜伏结核感染的因素。方法以上海市浦东新区和杨浦区四所小学四、五年级在校学生作为研究对象，问卷调查形式收集研究对象的基本信息和结核感染相关信息，结核感染T细胞斑点试验（T—SPOT．TB）技术了解结核感染情况，单因素和多因素分析研究影响小学生结核感染状况的因素。结果本研究共纳入小学生472名，其中有卡介苗接种史者439人，占93．0％，与结核患者既往有过接触的学生10人，占2．1％。472名小学生中16人T—SPOT．TB检测阳性，占3．4％，但无结核相关的临床症状和体征，为潜伏结核感染者。接种卡介苗者潜伏结核感染率为2．7％，未接种者为12．1％（OR：6．972，95％CI：1．834426．500）；有结核接触史者潜伏结核感染率为30．0％，无接触史者为2．8％（OR：16．38，95％CI：3．692～72．700）。结论上海市小学高年级学生的潜伏结核感染率为3．4％，卡介苗接种对预防上海学龄儿童潜伏结核感染有保护作用，而日常生活中与结核患者接触增加了儿童潜伏结核感染的危险性。Objective To investigate the prevalence of latent tuberculosis infection （LTBI）, and to identify the risk factors in primary schoolchildren from Shanghai through the population based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay （T-SPOT. TB） assay. Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai. Questionnaire interview was applied to investigate the socio demographic and clinical information related to LTBI. The T SPOT. TB assay was used to detect LTBI in the enrolled subjects. Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren. Results Totally 472 schoolchildren were enrolled in the present study, with 439 （93.0%） being vaccinated with bacillus ealmette-guerin （BCG） and ten （2. 1%） having contact history with tuberculosis （TB） patients. Among the 472 eligible subjects, 16 （3.4%） children were T-SPOT. TB positive, who had no clinical symptoms and signs relevant to TB and were defined as LTBI. The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%, respectively （OR： 6. 972; 95%CI： 1. 834-26. 500） those in TB contacts and children without TB contact history were 30. 0% and 2. 8%, respectively （OR： 16. 38; 95% CI： 3. 692- 72. 700）. Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

关 键 词：结核 接种 卡介苗 酶联免疫吸附测定 T淋巴细胞 儿童 

分 类 号：R725.1[医药卫生—儿科]