2019—2021年北京市石景山区定点医疗机构收治肺结核病例痰标本检测结果分析  

Sputum test results of tuberculosis patients registered in designated medical institutions from 2019 to 2021

作　　者：邰剑敏[1] 张绚 刘聪伟 邢玉鹏 常志帅 唐桂芹 张亚敬[1] TAI Jian-min;ZHANG Xuan;LIU Cong-wei;XING Yu-peng;CHANG Zhi-shuai;TANG Gui-qin;ZHANG Ya-jing(Shijingshan District Center for Disease Control and prevention,Beijing 10043,China.)

机构地区：[1]北京市石景山区疾病预防控制中心,北京100043

出　　处：《职业卫生与病伤》2022年第4期256-259,共4页Occupational Health and Damage

基　　金：首都卫生发展科研专项基金(项目编号:首发2022-IG-3012)。

摘　　要：目的分析石景山区结核病防治所(以下称“结防所”)收治肺结核病例痰标本中结核分枝杆菌的阳性检出情况,为相关部门政策制定提供依据。方法回顾性分析2019—2021年石景山区结核病防治所收治肺结核病例资料,采用SPSS 22.0软件分析数据,计数资料采用χ^(2)检验,P<0.05为差异有统计学意义,比较不同年份、不同检测方法(痰涂片、罗氏固体培养、GeneXpert MTB/RIF)的阳性检出率。结果2019—2021年,结防所登记管理的80例活动性肺结核病例,以男性(67.50%)本市户籍(58.75%)居多,初治患者69例(86.25%),复治患者11例(13.75%),职业分布以离退人员和干部职员占比较高,分别为25.00%和23.75%。2019—2021年肺结核患者病原学阳性率分别为62.07%,57.14%和80.00%;痰涂片阳性分别检出率分别为:17.24%、19.05%和23.33%,痰培养阳性检出率分别为34.50%、28.57%和50.00%,GeneXpert阳性检出率分别为:58.62%、57.14%和76.67%。同一年份3种检测方法阳性检出率比较,GeneXpert阳性检出率均最高,差异有统计学意义(P均<0.05)。80例肺结核病例中,利福平耐药阳性检出3例,利福平耐药率为3.75%。结论GeneXpert提高了肺结核病原学阳性检出率和利福平耐药检出效率,可以推广其在基层医疗机构应用。Objective To analyze the detection rates of Mycobacterium tuberculosis in sputum samples from patients with pulmonary tuberculosis in Shijingshan District tuberculosis control center,to provide basis for relevant departments to formulate policies.Methods Retrospective analysis was conducted on the data of tuberculosis cases in Shijingshan District tuberculosis control center in 2019-2021.The positive rates of different years,and different detection methods(sputum smear,Roche solid culture and GeneXpert MTB/RIF)were compared.SPSS 22.0 software was used for data analysis.Chi-square test was used for counting data.P<0.05 was considered as statistically significant.Results Totally,80 cases of active tuberculosis registered by the institute of tuberculosis control center were mostly males(67.50%),and registered residence in the city(58.75%).69 cases(86.25%)were newly treated,11 cases(13.75%)were retreated.Retired patients and cadres accounted for 25.00%and 23.75%of total cases.In 2019-2021,the positive rate of tuberculosis was 62.07%,57.14%and 80.00%,respectively.The positive detection rates in 2019-2021 of sputum smear,sputum culture and GeneXpert were 17.24%,19.05%,23.33%;34.50%,28.57%,50.00%;and 58.62%,57.14%,76.67%,respectively.The positive detection rates of the three detection methods in each of three years were compared,and the difference was statistically significant.Specifically,The positive detection rate of GeneXpert was the highest in each of three years.Among 80 cases of pulmonary tuberculosis,3 cases were detected by rifampin resistance,and the drug resistance rate was 3.75%.Conclusions The GeneXpert method improves the positive rate of detection efficiency of tuberculosis,and it can be popularized in primary medical institutions.

关 键 词：肺结核 痰检 利福平耐药 

分 类 号：R446.5[医药卫生—诊断学]