分类筛查在上海市闵行区入学新生肺结核筛查中的应用  

The Application of Classification Screening in Tuberculosis Screening for New Students Enrolled in Shaohang District, Shanghai

作　　者：吴蕴华[1] 苏华林[1] 唐利红[1] 赵亚萌 严慧琴[1] 马琼锦 王墩家 WU Yun-hua;SU Hua-lin;TANG Li-hong(Minhang District Center for Disease Control and Prevention,Shanghai,201101,China)

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101

出　　处：《中国初级卫生保健》2020年第11期63-65,共3页Chinese Primary Health Care

基　　金：上海市闵行区自然科学研究课题(2019MHZ126)。

摘　　要：目的发现上海市闵行区入学新生中肺结核患者及潜伏感染者,实施精准管理,以预防肺结核聚集性疫情的发生。方法对幼托机构、小学和非寄宿制初中新生开展结核病症状筛查及接触史筛查;寄宿制初中、中职校和高中新生开展症状筛查和PPD检测;大专、本科院校新生开展症状筛查和胸片检查。结果幼儿园、小学及非寄宿制初中新生中有肺结核接触史的分别为4人、5人和3人,共计12人,平均接触率为0.21‰;寄宿制初中、高中及中等职业技术学校新生PPD皮试,强阳性率分别为2.52%、2.50%和4.51%,三类人群强阳性率差异有统计学意义,总体阴性率、弱阳性率、中度阳性率和强阳性率分别为63.84%、24.12%、9.21%和2.83%;专科学校及本科院校新生胸片检查异常率分别为0.28%和0.18%;各类别学校2018学年新生总体可疑症状的比例为0.16%。对PPD试验强阳性及胸片异常学生作进一步检查,分别发现1例肺结核患者。结论入学新生分类筛查肺结核是符合不同阶段学生生理特征及卡介苗免疫状况的策略,但评价方法需要进一步探讨。OBJECTIVE To find out the pulmonary tuberculosis patients and latent infection in the new students of the schools in Minhang District,so as to implement prevision management of the key students and prevent the occurrence of pulmonary tuberculosis cluster epidemics.METHODS Tuberculosis symptom screening and contact history screening were carried out in nursery school,primary school and non-boarding junior middle school’ s freshmen;symptom screening and PPD testing were carried out in boarding junior middle school,secondary vocational and technical schools and senior high school freshmen;and symptom screening and chest radiography were carried out for junior college and university ’ s freshmen.RESULTS There were 4,5 and 3 new students in kindergarten,primary school and non-boarding junior middle school,with a total of 12 students had TB contact history,with an average exposure rate of 0.21‰.The strong PPD positive rates of the boarding junior middle school,secondary vocational and technical schools and senior high schools’ freshmen were 2.52%,2.50% and 4.51%,respectively.The negative rate of PPD testing of all students was 63.84%.The weak positive rate,moderate positive rate and strong positive rate were 24.12%,9.21% and 2.83%,respectively.The abnormal chest X-ray rates of junior college and university’ s freshmen were 0.28% and 0.18%,respectively.The suspicious symptoms rate of all new students was 0.16% in the year of 2018.1 cases of pulmonary tuberculosis was found by further examination of students with strong positive PPD testing and abnormal chest X-ray.CONCLUSION Applying classified screening of pulmonary tuberculosis in the new students was a strategy according with the physiological characteristics of students and the immune status of BCG,but the evaluation method of it needed to be further explored.

关 键 词：肺结核 学生 筛查 

分 类 号：R742[医药卫生—神经病学与精神病学]