涂阴肺结核流行传播特点与随访预后的文献结果分析  

Analysis on epidemic features and prognosis of smear-negative tuberculosis

作　　者：马艳[1] 李亮[2] 刘二勇[3] 成诗明[3] 

机构地区：[1]北京市结核病胸部肿瘤研究所中心办公室,101149 [2]首都医科大学附属北京胸科医院 [3]中国疾病预防控制中心结核病预防控制中心

出　　处：《中国防痨杂志》2015年第5期520-525,共6页Chinese Journal of Antituberculosis

摘　　要：目的回顾不同国家和地区涂阴肺结核流行传播的特点，涂阴肺结核治疗与不治疗随访后的结果、涂阴肺结核对密切接触者的感染危险，分析涂阴肺结核对结核病控制的影响。方法由课题专家和检索人员讨论后确定检索词（6个检索词，分别为涂阴肺结核、痰涂片阴性、传播与流行、治疗及预后、接触者、随访），共检索12个数据库3个卫生机构网站（世界卫生组织网、国家卫生和计划生育委员会及美国疾病预防控制中心）和搜索引擎Google Scholar。纳入发表于1960-2014年中的所有描述或评价涂阴肺结核流行及传播概况、治疗随访等资料和数据的文献，共检索到946篇文章（排除观点性文章、信件、社论、评论、文献目录、会议摘要等），对符合条件的16篇文献进行分析。结果涂阴肺结核不治疗进行18～65个月随访观察，患者痰菌转阳率为为40．0％（70／175）～57．9％（88／152）不等，死亡率为15．0％（50／334）；完成治疗后随访观察，患者痰菌转阳或胸片发生典型恶化者占3．9％（4／103）～32．7％（49／150），死亡率为3．2％（2／63）～36．0％（54／150）；对涂阴肺结核患者的密切接触者进行筛查随访，潜伏感染率为9．1％（13／143）～79．4％（27／34），5．7％（3／52）～9．0％（18／200）的密切接触者发展为活动性肺结核。结论加强对涂阴肺结核患者的早期诊断和治疗管理，对减少结核病的传播、控制结核病疫情具有重要的流行病学意义。Objective Systematic review on epidemic and transmission features of smear negative pulmonary tuberculosis, and the results of these patients with and no after-treatment follow up, their infection risk to close contacts, and to analyze smear-negative tuberculosis impact to TB control. Methods To determine key words by experts＇ discussion, include smear negative tuberculosis/sputum-negative tuberculosis, sputum smear negative, transmission and epidemiology, contacts, follow-up, we searched 12 database, 3 health agencies websites （World Health Organization network, National Health and Family Planning Commission of the People＇s Republic of China and the United States Centers for Disease Control and Prevention） and search engines Google Scholar, Our inclusion criteria were research papers that describing or evaluating epidemic and transmission, treatment and follow up of smear-negative pulmonary tuberculosis, 946 studies （published in 2000-2013） were retrieved, except view articles, letters, news, editorials, reviews, bibliography and conference summary, 16 full papers were included and analyzed. Results Sputum bacteria positive conversion rate was 40.0%（70/175） -57.9%（88/152）, mortality was 15.0% （50/334） by 18-65 months follow-up for smear-negative pulmonary tuberculosis patients without trealment; sputum bacteria positive conversion or chest radiograph typicality changes accounted for 3.9 （4/103） - 32.7 % （49 / 150） and mortality was 3.2% （2/63）- 36.0% （54/150） follow-up after treatment; latent infection rate was 9.1% （13/143）-79.4%（27/34） in their close contacts and 5.7%（3/52）-9.0%（18/200） of close contacts developed active tuberculosis by follow-up screening. Conclusion To strengthen early diagnosis, treatment and management of smear-negative tuberculosis, is of epidemiological significance to reduce transmission and control tuberculosis epidemic.

关 键 词：结核 肺/传播 接触者追踪 随访研究 预后 评价分析 

分 类 号：R521.05[医药卫生—内科学]