涂阳肺结核患者密切接触者的结核病检出情况分析  

Analysis of TB case detection through investigation of close contacts of smear positive pulmonary tuberculosis patients

作　　者：高翠南[1] 谭青云[1] 许卓卫[1] 罗少霞[1] 

机构地区：[1]广州市胸科医院,广州510095

出　　处：《中国防痨杂志》2011年第6期328-330,共3页Chinese Journal of Antituberculosis

基　　金："艾滋病和病毒性肝炎等重大传染病防治"科技重大专项"结核病发病模式研究"(2008ZX10003-007);中国全球基金结核病项目实施性研究课题(TB08-003);2008年广东省社会发展领域科技计划项目(83095)

摘　　要：目的了解涂阳肺结核患者密切接触者中肺结核的发病情况,为结核病防控策略的制定提供科学依据。方法通过对1 138例涂阳肺结核患者的家庭密切接触者的X线和痰涂片检查来分析他们的结核病患病情况。同时,分析涂阳肺结核患者的密切接触者中患者配偶、父母和子女以及有无结核可疑症状者的家庭密切接触者和不同排菌程度肺结核患者的密切接触者中肺结核患者的检出情况。结果涂阳肺结核患者家庭密切接触者中活动性肺结核患者的检出率为3.3%;涂阳肺结核患者家庭密切接触者中活动性肺结核患者的检出率配偶最高,分别是患者父母的1.9倍和患者子女的16倍;有结核可疑症状者的活动性肺结核患者检出率是无结核可疑症状者的活动性肺结核患者检出率的6.4倍,2者差异有统计学意义(μ=7.8,P<0.01);涂片3+患者的密切接触者中活动性肺结核患者的检出率比涂片2+患者和涂片1+患者的密切接触者分别高出1.8和2.4个百分点。结论涂阳肺结核患者家庭密切接触者的结核病患病情况明显高于普通人群,特别是对患者的配偶、家庭密切接触者中有结核可疑症状者和排菌严重肺结核患者的家庭密切接触者应重点关注。因此,应加强对涂阳肺结核患者家庭密切接触者的监测和检查,尽早发现患者,缩短肺结核患者对正常人群的感染传播。Objective To investigate the status of TB case detection through investigation of close contacts of smear positive tuberculosis patients,provide scientific basis for the development of TB prevention and control strategy. Methods The household close contacts of 1 138 smear positive TB cases were investigated by X-ray and sputum smear test.The yield of TB cases in patient＇s spouses,parents and children and in contacts with or without suspicious TB symptoms were analyzed respectively.The yield in contacts of patients with different level of smear results was also compared. Results The yield of active PTB was 3.3% in household close contacts of smear positive PTB cases.The detection rate of active PTB was highest in spouses which was 1.9 times and 16 times higher than in the parents and the children of patients,respectively.The detection rate was 6.4 times higher in close contacts with suspicious TB symptoms than without symptoms.And the detection rate between these two groups are significant different（μ=7.8,P0.01）. Conclusions The prevalence of active PTB is significantly higher in household contacts than in general population,especially for the spouses of the patients.We should give special attention to contacts with suspicious TB symptoms and household contacts of patients with higher level of bacterial discharge.Therefore,we should strengthen the monitoring and examination of close contacts of smear positive PTB patients in order to detect the patients as early as possible and shorten the TB spreading period to the healthy population.

关 键 词：结核 肺/预防与控制 接触者追踪 

分 类 号：R521[医药卫生—内科学]