北京市朝阳区2013—2015年高校新生结核菌潜伏感染现状及发病情况  

Latent tuberculosis infection and tuberculosis incidence college freshmen in Chaoyang District during 2013 to 2015

作　　者：梁瑞英[1] 徐伟[1] 吴春萍[1] LIANG Ruiying;XU Wei;WU Chunping(Beijing Chaoyang istrict Center for Disease Control and Prevention,Beijing,100021,China)

机构地区：[1]北京市朝阳区疾病预防控制中心

出　　处：《中国学校卫生》2019年第9期1373-1375,1379,共4页Chinese Journal of School Health

摘　　要：目的了解北京市朝阳区2013-2015年高校新生结核菌潜伏感染(latent tuberculosis infection, LTBI)及随访发病情况,为学校结核病防控工作提供依据。方法采用结核菌素纯蛋白衍生物(TB-PPD)皮肤试验进行结核菌潜伏感染的检测,收集整理2013-2015年朝阳区65 233例高校新生的入学结核病筛查及感染者后期发病的相关资料,并对资料进行描述性统计分析。结果 65 233例新生中,有效PPD试验结果63 135例,PPD阳性11 754例(18.62%),PPD强阳性2 720例(4.31%)。男生PPD阳性率及强阳性率(19.56%,4.76%)均高于女生(17.87%,3.95%)(χ~2值分别为29.37,24.29,P值均<0.01),藏族(29.45%,8.69%)高于汉族(18.25%,4.16%)(χ~2值分别为102.01,70.04,P值均<0.01),西部生源(21.88%,5.11%)最高、本市生源(16.25%,3.46%)较低(χ~2值分别为220.63,99.03,P值均<0.01),有卡痕者(18.94%,4.34%)略高于无卡痕者(16.96%,4.08%)(χ~2值分别为48.46,10.43,P值均<0.01)。筛查发现结核病患者19例,患病率为29.13/10万,其中PPD强阳性而发现者占68.42%(13/19)。单纯PPD强阳性预防性服药率为52.94%(1 433/2 707)。随访单纯强阳性学生2年共发现结核病患者7例,年均发病率为129.29/10万(7/2 707)。结论朝阳区高校新生LTBI处于相对较低水平,但对于来自结核病疫情高发地区或藏族等少数民族的学生应重点关注,继续开展新生PPD筛查。LTBI者是结核病发病高风险人群,应对其在校期间密切定期观察。Objective To understand the prevalence of latent tuberculosis infection(LTBI) among college freshmen in Chaoyang District of Beijing from 2013 to 2015, and to provide evidence for prevention and control of tuberculosis in schools. Methods The latent tuberculosis infection was identified through a tuberculin purified-protein derivative(TB-PPD) skin test. TB-PPD test results of 65 233 college students in the Chaoyang District during 2013 to 2015 were collected and stored, by using descriptive statistical analysis. Results Among the 65 233 freshmen, 63 135 were effective PPD test results, 11 754 were PPD positive, 2 720 were PPD strong positive, the LTBI status: the PPD positive rate was 18.62% and the PPD strong positive rate was 4.31%. The positive rate and the strong positive rate in male(19.56%, 4.76%) were higher than that in female(17.87%, 3.95%)(χ~2=29.37, 24.29), in ethnic minorities were higher than that in Han Nationality(18.25%,4.16%) and in Tibetans(29.45%, 8.69%) were the highest(χ~2=102.01, 70.04), among freshmen from the western region(21.88%, 5.11%)were the highest and from Beijing city(16.25%, 3.46%) were lower(χ~2=220.63, 99.03, P<0.01), among those with BCG scar(18.94%, 4.34%) are slightly higher than those without BCG scar(16.96%, 4.08%)(χ~2=48.46, 10.43, P<0.01). 19 cases of tuberculosis patients were found, the prevalence rate was 29.13/100 000(19/65 233), of which 68.42%(13/19) were found through the strong positive for PPD. Among the strong positive students(2 707), there were 1 433(52.94%) who received preventive therapy, and during the follow-up two years, 7 were newly diagnosed with tuberculosis, the annual incidence rate was 129.29/100 000(7/2 707). Conclusion Freshmen from high-risk areas of tuberculosis are the focus of tuberculosis screening, for which we should continue to carry out PPD screening. Those with latent tuberculosis infection are high-risk groups of tuberculosis, and should be paid more attention in the prevention and control of tuberculosis in schools.

关 键 词：结核 感染 发病率 结核菌素试验 学生 

分 类 号：R521[医药卫生—内科学] R183[医药卫生—临床医学]