主动筛查方式下云南省6个偏远农村肺结核患病情况分析  

The TB epidemic situation under active screening in six remote villages in Yunnan Province

作　　者：王芸[1] 许琳[1] 邱玉冰[1] 侯景龙[1] 陈留萍[1] 

机构地区：[1]云南省疾病预防控制中心,云南昆明650022

出　　处：《现代预防医学》2014年第19期3606-3608,3620,共4页Modern Preventive Medicine

摘　　要：目的了解主动筛查方式下云南省偏远农村地区肺结核患病情况。方法采用多阶段分层整群等比例随机抽样方法对6个村15岁及以上常住人口进行问卷症状筛查、胸部X线摄片检查、痰涂片和痰培养检查。结果 6个村共筛查9 305人,检出活动性肺结核101例,其中新发现95例,已知6例。活动性肺结核患病率为1 085.44/10万,远高于同期疾病监测信息报告管理系统报告发病率的全省平均水平(55.6/10万)和最高县的水平(镇雄县180.34/10万)。7例结核合并尘肺的患者均检自一个拥有煤矿区的村子,占该村发现患者数的32%。92.5%的筛查对象和60.40%的肺结核患者无咳嗽咳痰≥2周肺结核可疑症状。不同性别、年龄、民族、有无肺结核可疑症状人群的肺结核患病率差异有统计学意义。结论 6个村肺结核疫情严峻,开展主动筛查能极大提高患者发现的力度。男性、少数民族、60岁及以上老年人是肺结核患病的高危人群。矿区应作为肺结核筛查的重点地区。仅靠症状筛查不能发现无肺结核可疑症状的隐匿患者。Objective To analyze the TB epidemic situation under active screening in six remote villages in Yunnan province.Methods The stratified cluster proportional random sampling method was used to select the screening population.People over 15 years old were investigated by questionnaire,chest X-ray examination,and sputum smear and sputum culture examination.Results9305 were actually examined in six villages and 101 active pulmonary tuberculosis（PTB） cases were detected,among whom 95 were new cases,and 6 cases were known before this survey.The prevalence of active PTB was 1 085.44/100 000,which was far higher than the provincial average level（55.6/100 000） and the top one prevalence（180.34/100 000） in the whole province reported by the disease surveillance information management system in the same period.7 PTB cases with pneumoconiosis came from the same village with a coal mine area,accounted for 32% cases in the village.92.5% respondents and 60.40% PTB cases were without the cough symptoms over 2 weeks.There were significant difference of TB prevalence between different gender,age,nationality,and having suspicious TB symptoms or not.Conclusion The PTB epidemic is serious in the six villages.By active screening,the strength of finding patients can be greatly improved.Male,ethnic minorities,60 years old and over group are high-risk groups of PTB.Mining area should be taken as a key TB screening area.PTB cases without TB suspicious symptoms cannot be found relying on the symptom screening.

关 键 词：主动筛查 农村 肺结核 

分 类 号：R183[医药卫生—流行病学]