江油市农村结核病患者主动发现效果分析  

Analysis on Active Discovery Effect of the Rural Tuberculosis Patients in Jiangyou City

作　　者：夏岚[1] 张佩如[1] 曹婕[2] 饶正远[1] 刘平 宋杨[1] 龙波[1] 罗磊[3] 肖月[1] 高文凤[1] 杨筠[1] 孙宏英[3] 杨妮[1] 吴建林[1] XIA Lan;ZHANG Peiru;CAO Jie;RAO Zhengyuan;LIU Ping;SONG Yang;LONG Bo;LUO Lei;XIAO Yue;GAO Wenfeng;YANG Jun;SUN Hongying;YANG Ni;WU Jianlin(Sichuan Center for Disease Control and Prevention, Chengdu 610041 , Sichuan Province, China;Jiangyou City Center for Disease Control and Prevent ion , Jiangy ou 621700, Sichuan Province, China;Mianyang Municipal Center for Disease Control and Prevention , Mianyang 621000 , Sichuan Province, China.)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]江油市疾病预防控制中心,四川江油621700 [3]绵阳市疾病预防控制中心,四川绵阳621000

出　　处：《寄生虫病与感染性疾病》2019年第1期23-27,共5页Parasitoses and Infectious Diseases

基　　金：国家"十二五"科技重大专项课题(项目编号:2013ZX10003004-001-009)

摘　　要：目的评价在四川省江油市实施的主动发现结核病患者研究效果,探索西部农村地区开展结核患者主动发现对策与措施。方法通过对研究现场居住、工作和学习6个月以上的全部常住人口进行结核病可疑症状筛查,15岁及以下人群进行结核菌素(PPD)试验,对具有肺结核可疑症状者、PPD试验强阳性者及研究重点人群进行胸部X线摄片检查和痰涂片、痰培养检查并确诊,采用χ~2检验、Fisher确切概率法,非参数检验等方法比较主动发现和被动发现方式效果,分析患者特征。结果研究期间共调查32 071人,发现结核病可疑症状者497人、活动性结核病患者117人,期间患病率为363. 15/10万,显著高于当地前3年报告发病率,男性、65岁及以上、外来人口、农民的结核病可疑症状出现风险分别是其他人群的3. 44倍、4. 69倍、3. 85倍和3. 03倍;患病风险分别是其他人群的3. 39倍、9. 36倍、1. 72倍和2. 78倍。检出的活动性患者中有52例(44. 44%)没有咳嗽、咳痰超过2周等结核病可疑症状,菌阳患者中也有7例(28. 00%)无结核病可疑症状。对6 074名肺结核患者的密切接触者、≥65岁老年人、糖尿病患者及HIV/AIDS患者、既往结核病患者进行了胸部X线检查,确诊活动性结核病患者87人,占全人群活动性结核病患者的74. 36%,人群患病率为1 401/10万。其中既往肺结核患者患病率最高,是全人群患病率的30. 18倍。结论仅开展结核病可疑症状筛查不能发现近一半活动性患者,而开展结核病主动筛查能显著提高结核病发现水平,在既往结核病患者和65岁以上老年人中开展主动筛查效率较高。Objective To evaluate the effect of the active discovery of the tuberculosis patients in Jiangyou city,Sichuan province,so as to explore the countermeasures and measures for the detection of tuberculosis patients in the western rural areas. Methods The suspicious symptoms of tuberculosis were screened among all the residents who lived,worked and studied for more than 6 months,the patients aged 15 years and under were tested with tuberculin( PPD). Chest X-ray examination, sputum smear and sputum culture examination were performed in the population with suspicious symptoms of tuberculosis, strong positive individuals and the key research population. The results of active and passive detection were compared and the characteristics of the patients were analyzed. Results A total of 32 071 people were investigated during the study period,497 peoplewere found to have suspicious symptoms of tuberculosis,117 were active TB patients,and the prevalence rate during the period was 363. 15/105,which was significantly higher than the incidence rate reported in the previous three years of the local population. Male,65 years old and over and immigrant population,being a famer were the risk of suspicious symptoms of tuberculosis,with the risk of3. 44 times,4. 69 times,3. 85 times and 3. 03 times of that of other population,respectively. The risk of disease was 3. 39 times,9. 36 times,1. 72 times and 2. 78 times of other population respectively. There were52( 44. 44%) of the active patients found to have no cough,expectoration for more than 2 weeks and other suspicious symptoms of tuberculosis,7( 28. 00%) of the active patients had no such suspicious symptoms of tuberculosis. Chest X-ray examination was performed on 6 074 patients with pulmonary tuberculosis,also performed on people aged more than 65,diabetes mellitus and HIV/AIDS,87 of them were diagnosed with active tuberculosis,accounted for 74. 36% of the total active tuberculosis patients,the prevalence rate was1 401/105. The prevalence rate of previous pulmonary tuberculosis

关 键 词：结核 肺 西部农村 主动发现 效果评价 

分 类 号：R521[医药卫生—内科学] R195.4[医药卫生—临床医学]