广东汉族家庭聚集性发病的肺结核病人及家庭密切接触者调查情况分析  

Investigative analysis of pulmonary tuberculosis patients and their close contacts in families of Guangdong Han Nationality

作　　者：吴睿彦[1] 陈品儒[1] 许柳清[1] 谭毅刚[1] 梁小成[1] 李天义[1] 邱薇[1] WU Ruiyan;CHEN Pinru;XU Liuqing;TAN Yigang;LIANG Xiaocheng;LI Tianyi;QIU Wei(Guangzhou Chest Hospital/Severe Tuberculosis Medicine Zone 1,Guangzhou 510095,China;不详)

机构地区：[1]广州市胸科医院,广东广州510095

出　　处：《现代医院》2021年第4期620-622,共3页Modern Hospitals

基　　金：广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号);广东省转化医学创新平台培育建设项目B类(粤卫函[2018]1254号)资助。

摘　　要：目的通过对家庭聚集性发病的广东汉族肺结核病人及家庭密切接触者患病情况进行分析,初步探讨家庭遗传因素对罹患结核病的影响。方法回顾分析结核病患者及家庭密切接触者210人,检查对象进行痰(胸液、脑脊液、腹水等)涂片找抗酸杆菌、抗酸杆菌培养及菌种鉴定、Gene Xpert MTB、TB-DNA、TB-RNA,IGRAs、结核菌素纯蛋白衍生物皮试实验、影像学检查等,对检查结果进行对比分析。结果家庭聚集性发病的肺结核病人,患者发病年龄段主要集中在青壮年,青少年儿童及老年人不少见;男性多于女性。直系亲属结核病发生率38.2%高于夫妻同时患病的发生率20.3%,有极显著差异(P<0.01);被感染发病的直系亲属中,有55%的成员肺部病变累及多肺叶并不高于夫妻组62%;但直系组有60%患或合并肺外结核病,高于夫妻组12.5%。结论广东汉族家庭聚集性发病的肺结核病人家庭内,病人直系亲属可能更易罹患结核病,存在遗传因素影响。Objective To analyze the prevalence of pulmonary tuberculosis patients and family close contacts in Guangdong Han nationality with family clusters,and to preliminarily explore the influence of family genetic factors on tuberculosis.Methods A retrospective analysis of 210 tuberculosis patients and close family contacts was performed.Sputum(thoracic fluid,cerebrospinal fluid,ascites,etc.)smears were performed to find acid-fast bacilli,acid-fast bacillus culture and strain identification,Gene Xpert MTB,TB-DNA,TB-RNA,IGRAs,tuberculin pure protein derivative skin test experiment,imaging examination,etc.,and the examination results were compared and analyzed.Results For pulmonary tuberculosis patients with family clusters,the age group of patients was mainly young and middle-aged.Adolescents and children and the elderly were not uncommon;there were more men than women.The incidence of tuberculosis in immediate relatives was 38.2%higher than that of couples,which stood at 20.3%;the difference is highly statistically significant(P<0.01).Among the immediate family members,55%of members had lung lesions involving multiple lobes,which was not higher than 62%in the couples group;but 60%of the immediate family members had or had extrapulmonary tuberculosis,and 12.5%in the high couples group.Conclusion In the families of pulmonary tuberculosis patients with cluster-onset of Han nationality in Guangdong,the immediate family members of the patients may be more likely to develop tuberculosis due to genetic factors.

关 键 词：结核病 密切接触者 遗传因素 

分 类 号：R197[医药卫生—卫生事业管理]