深圳市2013年门诊结核病人流行病学调查分析  

Investigation on epidemiology of outpatient with tuberculosis in Shenzhen

作　　者：张弛[1] 吴俊英[1] 杨倩婷[2] 林玲[1] 李晋[2] 张明霞[2] 陈心春[2] 

机构地区：[1]蚌埠医学院研究生部,安徽蚌埠233000 [2]深圳市第三人民医院,深圳市感染免疫重点实验室,广东深圳518112

出　　处：《临床肺科杂志》2015年第9期1560-1563,共4页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金项目(No 81301389);广东省医学科研基金(No B2014354)

摘　　要：目的了解深圳市门诊结核病流行情况,分析现有临床检查对于在临床结核诊断中的应用情况。方法收集深圳市第三人民医院2013年1月至2013年12月就诊肺科门诊的病人的各项检查结果资料,回顾性分析各项诊断指标对结核病人诊断中的实际应用价值和效果。结果 2013年深圳市第三人民门诊病人为7726例,门诊诊断为结核病4378,阳性率为56.5%。其中3842例诊断为肺结核病人,各项检查结果阳性率分别为:痰培养27.2%,痰涂片10.6%,结核杆菌PCR 18.8%,结核杆菌抗体测定58.3%,IFNγELISPOT检测53.2%。536例诊断为肺外结核确诊病人,各项检查结果阳性率分别为:痰培养21%,痰涂片7.6%,结核杆菌PCR 13.8%,结核杆菌抗体测定62.2%,IFNγELISPOT检测63.1%。肺外结核病人中,按不同感染部位进行分类,结核杆菌抗体测定和IFN-γElispot检测仍然有较高的检出率。结论各项实验室检查只能为医生对结核病诊断提供一个参考初筛。面对大量门诊病人和各种疾病,还需要医生结合病情作出诊断。Objective To investigate the epidemiology situation of outpatients with tuberculosis in Shenz-hen. Methods The examination results of outpatients with tuberculosis in the Third People′s Hospital of Shenzhen were collected from January 2013 to December 2013, and the diagnostic criteria of practical value and effectiveness were retrospectively analyzed. Results 7726 outpatients were enrolled, and 3842 cases were diagnosed as pulmona-ry tuberculosis. The positive rate of the test was as follow： 27. 2% of sputum culture, 10. 6% of sputum smear, 18. 8% of Mycobacterium tuberculosis, 58. 3% of Mycobacterium tuberculosis antibody determination, and 53. 2% of IFNγ ELISPOT assay. 536 cases were diagnosed as extra-pulmonary tuberculosis, and the positive rate of the test re-sults was as follow： 21% of sputum culture, 7. 6% of sputum smear, 13. 8% of Mycobacterium tuberculosis PCR, 62. 2% of Mycobacterium tuberculosis antibody determination, and 63. 1% of IFNγ ELISPOT assay. In extra-pulmo-nary tuberculosis patients, tuberculosis antibody determination and IFN-γ ELISPOT assay still had a higher detection rate according to the classification of the different infection sites. Conclusion The laboratory tests can just provide an evidence for the initial diagnosis of tuberculosis, and the doctor in outpatient should make the last diagnosis ac-cording the actual condition.

关 键 词：结核病 诊断 门诊病人 

分 类 号：R52[医药卫生—内科学]