2010—2014年上海口岸赴美移民活动性肺结核检出情况分析  

Analysis of TB screening results among applicants for immigration to the United States at Shanghai port from 2010 to 2014

作　　者：潘佳鸿[1] 陈磊[1] 周娴[1] 孟成艳[1] 潘俊[1] 王惟信 蔡蕾[1] 叶魏[1] 章琪[1] 

机构地区：[1]上海国际旅行卫生保健中心,上海200335

出　　处：《中国国境卫生检疫杂志》2015年第6期409-412,共4页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的了解上海口岸赴美移民活动性肺结核的流行情况,防止结核病通过口岸跨境传播。方法按照美国2009年《移民结核病筛查与治疗技术指南》要求,对2010年1月—2014年12月上海口岸赴美移民人群进行活动性肺结核筛查和治疗。结果 2010年1月—2014年12月上海口岸赴美移民17 869名,共检出活动性肺结核患者23例,总检出率为128.71/10万;男性检出率为147.33/10万;女性检出率为115.35/10万;男女性别比为1.28∶1。检出率随年龄的增长而上升,20-30岁年龄组有一个小高峰,为200.8/10万;〉70岁年龄组达到最高峰,为297.62/10万,60-70岁年龄组与〉70岁年龄组检出率相当,为291.97/10万。经细菌学检测,23例患者中,检出涂阳培阳3例、涂阴培阳15例、涂阳培阴3例和涂阴培阴2例;18例菌株均属结核分枝杆菌;药敏试验结果为敏感株14例,耐药株4例（1例为耐多药肺结核（MDR-TB）[1],2例为单耐异烟肼,1例为单耐链霉素）。结论应加强对口岸重点人群（20-30岁和〉60岁）的结核病监测,将胸部X射线检查与痰结核杆菌检测结合起来,可提高活动性肺结核的检出率。Objective To investigate the prevalence status of active tuberculosis（TB）among applicants for immigration to the United States at Shanghai port, thereby preventing TB transmission across national boundaries.Methods Accordance to Technical Instructions for Tuberculosis Screening and Treatment by US CDC in 2009 from Jan. 2010 to Dec.2014, 17 869 immigration applicants to the United States（US） at Shanghai port were received TB screening and treatment. Result There were 23 cases active TB among applicants for immigration to the United States, detection rate was 128.71 / 100 000. The prevalence in male（147.33 / 100 000） was higher than in female（115.35 / 100 000）, and gradually increase by age, peaked in 70 years old（297.62 / 100 000）.The detection rate in 60-70 years old（291.97 / 100 000） was correspond in 70 years old（297.62 / 100 000）. The next peak was in20-30 years old（200.8 / 100 000）. By bacteriological examinations, among 23 case, 3 cases were smear positive and culture positive（S＋C＋）,15 cases were smear negative but culture positive（S-C＋）, 3 cases were smear positive and culture negative（S＋C-） and 2 cases were smear negative and culture negative（S-C-）.All of the 18 culture positive cases were identified as MTB complex,14 of them were confirmed by DST as susceptible TB while other 4 were drug-resistant TB（1 was MDR-TB,2 was resistant to isonaizid and 1 was resistant to streptomycin）. Conclusion It is necessary to strengthen TB screening in target populations（20-30 years old and 60 years old） during immigration health check to control transmission of tuberculosis by travelers. Combine the chest X-ray and bacteriological examinations should be used to enhance the detection rate of active TB.

关 键 词：肺结核 赴美移民 上海口岸 

分 类 号：R52[医药卫生—内科学]