南宁市高校结核病密切接触者不同剂型结核菌素试验结果比较  

Comparison of the effect of screening test for different tuberculin dosage forms for close contacts of tuberculosis in colleges and universities in Nanning

作　　者：李小媛[1] 杨绍湖[1] 黄鸿玉 邓春丽 谢柳媛 石健[1] LI Xiaoyuan;YANG Shaohu;HUANG Hongyu;DENG Chunli;XIE Liuyuan;SHI Jian(Department of Tuberculosis Control,Nanning Center for Disease Control and Prevention,Nanning 530023,China)

机构地区：[1]南宁市疾病预防控制中心结核病防制科,广西530023

出　　处：《中国学校卫生》2021年第5期768-771,775,共5页Chinese Journal of School Health

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20200583)。

摘　　要：目的了解南宁市高校肺结核密切接触者结核菌素试验使用不同剂型筛查效果的异同,为高校结核病防控工作提供依据。方法南宁市高校2018—2019年共7 771名筛查对象同时进行症状、结核菌素皮肤试验(TST)、X线胸片筛查及结果分析,2018、2019年TST分别使用2IU、5IU结核菌素纯蛋白衍生物(TB-PPD)试剂。结果两年共检出阳性人数916例,总阳性率11.79%;强阳性人数184例,强阳性率2.37%,共检出肺结核患者17例。大学一至四年级阳性率分别为13.88%,8.57%,10.59%,10.29%,差异有统计学意义(χ^(2)=46.30,P<0.01)。两年男、女生总阳性率分别为13.24%(500/3 777),10.42%(416/3 994),差异有统计学意义(χ^(2)=17.84,P<0.01);不同性别TST中度以上阳性者肺结核检出率差异无统计学意义(χ^(2)=0.29,P=0.59)。不同剂型比较,2IU、5IU剂型阳性检出率分别为7.57%及15.04%,差异有统计学意义(χ^(2)=114.41,P<0.01)。2 IU、5 IU剂型TST中度以上阳性者肺结核检出率分别为6.92%和2.07%,差异有统计学意义(χ^(2)=6.60,P=0.02)。结论使用5 IU剂型可以发现更多的阳性者(含中度阳性、强阳性);5 IU剂型可能对于发现肺结核患者与2 IU剂型比较无优势,但是在减少续发病例控制学校疫情方面意义更重大。Objective To understand the similarities and differences in different dosage forms of tuberculin test for college students having close contact with tuberculosis in Nanning colleges and universities in order to provide reference for the prevention and control of tuberculosis. Methods A total of 7 771 students were screened for symptoms and tuberculin skin test(TST)、X radiographs from 2018 to 2019 in Nanning.The used doses of Purified Protein Derivative of Tuberculin(TB-PPD) in 2018 and 2019 were 2 IU and 5 IU respectively. Results A total of 916 positive cases were detected in 2 years, with the total positive rate of 11.79%. Total strong positive number was 184 and the strong positive rate was 2.37%. The number of tuberculosis patients was 17. Positive rate of the students from grade one to grade four was 13.88%, 8.57%, 10.59%, 10.29%, respectively. The difference was statistically significant(χ^(2)=46.30,P<0.01). The positive rates of male and female in the past two years were 13.24%(500/3 777) and 10.42%(416/3 994), respectively(χ^(2)=17.84, P<0.01),and there was no significant difference in the diagnosis of pulmonary tuberculosis among TST positive patients(χ^(2)=0.29,P=0.59). The positive and strong positive rates of 2 IU dose and 5 IU dose were 7.57%, 15.04%, respectively, the difference in dosage forms were statistically significant(χ^(2)=114.41,P<0.01). The tuberculosis case detection rate(CDR) of moderate & above positive subjects of 2 IU and 5 IU dose was 6.92% and 2.07%, respectively, the difference was statistically significant(χ^(2)=6.60,P=0.02).Conclusion More positive tuberculosis cases(including moderate & strong positive) can be detected by using 5 IU dose, though it is may not have advantage over discovering tuberculosis patients comparing to 2 IU dose. However, it is more critical to minimize the following cases and control the outbreak in university.

关 键 词：结核 结核菌素试验 患病率 学生 

分 类 号：R183[医药卫生—流行病学] R446[医药卫生—公共卫生与预防医学]