儿童接种卡介苗3～6年后PPD结果及其对结核潜伏感染的影响  

PPD results after 3-6 years of BCG vaccination and its effect on latent tuberculosis infection in children

作　　者：孔雯[1] 丁晓艳[1] 竺丽梅[1] 陆峰[2] 李晨[3] 蒋俊 许祝平[5] 孙建设 刘泓 蒋晖[8] 缪昌东 陆伟[1] KONG Wen;DING Xiaoyan;ZHU Limei;LU Feng;LI Chen;JIANG Jun;XU Zhuping;SUN Jianshe;LIU Hong;JIANG Hui;MIAO Chang-dong;LU Wei(Jiangsu Center for Disease Control and Prevention,Nanjing,210009,China)

机构地区：[1]江苏省疾病预防控制中心慢性传染病防制所,南京210009 [2]南通市疾病预防控制中心 [3]南京市疾病预防控制中心 [4]苏州市疾病预防控制中心 [5]无锡市疾病预防控制中心 [6]徐州市疾病预防控制中心 [7]扬州市疾病预防控制中心 [8]镇江市疾病预防控制中心 [9]泰州市疾病预防控制中心

出　　处：《中国学校卫生》2019年第9期1366-1368,共3页Chinese Journal of School Health

基　　金：结核病感染筛查新技术及其在结核病主动发现中的应用研究课题项目(LGY2017083)

摘　　要：目的了解卡介苗接种后的学龄前儿童结核菌素试验(PPD)结果,为精确推测卡介苗接种对学龄前儿童的保护效果提供参考。方法 2018年1-11月,选取江苏省8个直辖市14所幼儿园的学龄前儿童1 359名进行结核菌素试验(PPD)检测,并对PPD结果强阳性儿童进行胸部X线检查。结果江苏省学龄前儿童PPD阳性率为23.33%,其中强阳性和中度阳性率(PPD≥10 mm)合计为6.47%。男童阳性反应149例(21.29%),女童阳性反应168例(25.50%),不同性别儿童PPD阳性反应结果差异无统计学意义(χ~2=3.36,P>0.05)。苏北地区儿童阳性反应201例(25.35%),苏南地区116例(20.50%),不同地区PPD阳性反应差异有统计学意义(χ~2=4.35,P<0.05)。3岁儿童PPD中度及以上阳性1例(0.71%),4岁儿童19例(3.89%),5岁儿童31例(8.96%),6岁儿童37例(9.63%),不同年龄组之间PPD阳性反应结果差异有统计学意义(χ~2=21.69,P<0.01)。结论江苏省学龄前儿童的PPD中度及以上阳性率较低,PPD可以作为儿童潜伏结核感染的检测手段。卡介苗接种对学龄前儿童的保护作用已经在明显下降,应采取相应措施保护易感儿童,有效防控儿童结核病。Objective To understand the results of tuberculin skin test(PPD) in preschool children after the vaccination of BCG, and to analyze the effect of BCG vaccination on latent tuberculosis infection in children. Methods From January to November 2018, a total of 1 359 preschool children from 14 kindergartens in 8 districts and cities of Jiangsu Province were selected for tuberculin test(PPD), and chest X-ray examination was performed on children with strong PPD results. Results The positive rate of PPD in preschool children in Jiangsu Province was 23.33%, of which strong positive and moderate positive(PPD≥10 mm) were totaled 6.47%. There were 149 boys(21.29%) with PPD positive reactions and 168 girls(25.50%) with PPD positive reactions, and differences of PPD positive reactions with different genders were of no statistical significance(χ~2=3.36, P>0.05) And there were 201 children(25.35%) with PPD positive reactions in northern Jiangsu, 116 children(20.50%) with PPD positive reactions in southern Jiangsu. There were significant differences in the results of PPD positive and negative reactions between different regions(χ~2=4.35, P<0.05). There was 1 case of PPD positive reactions among 3-year-old children(0.71%), 19 cases among 4-year-old children(3.89%), 31 cases among 5-year-old children(8.96%), and 37 cases among 6-year-old children(9.63%), and the differences of PPD positive reactions of different age groups were of statistical significance(χ~2=21.69, P<0.01). Conclusion The positive rate of PPD in preschool children in Jiangsu Province is very low, indicating that PPD can be used as a detection method for latent infection in children. The overall positive rate of PPD in preschool children in Jiangsu Province is also low, and appropriate measures should be taken to protect susceptible children and effectively prevent and control childhood tuberculosis.

关 键 词：接种 卡介苗 结核菌素试验 结核 感染 儿童 

分 类 号：R186[医药卫生—流行病学] R521[医药卫生—公共卫生与预防医学]