遵义地区儿童结核感染的流行病学调查及早期诊断方法  

Epidemiological investigation and early diagnosis of tuberculosis in chil dren in Zunyi district

作　　者：刘婷婷 LIU Tingting(The First People’s Hospital of Zunyi City,The Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义市第一人民医院,遵义医科大学第三附属医院,贵州遵义563000

出　　处：《当代医药论丛》2022年第21期72-74,共3页

基　　金：遵义市第一人民医院2019年联合科技研发资金项目“遵义地区儿童结核感染的流行病学调查及早期诊断指标”阶段性研究成果,项目编号:2019-HZ-184。

摘　　要：目的:调查遵义地区儿童结核感染的流行病学并分析其早期诊断方法。方法:本研究采集2019年7月至2021年7月遵义地区的500例结核感染患儿,对其一般资料和临床诊疗资料进行回顾性分析,归纳其临床特点,总结遵义地区儿童结核感染的流行情况,同时将结核感染儿童作为结核感染组,并选取同期500例健康体检儿童作为对照组,对两组儿童均进行结核感染T细胞斑点试验(T-SPOT.TB试验)、核菌素试验(PPD试验)及胸部CT检查,观察采用这三种方法诊断儿童结核感染的效能。结果:性别分布方面,500例结核感染患儿中有男298例(59.6%),女202例(40.4%),男性患儿的构成比明显高于女性患儿(P<0.05);年龄分布方面,年龄最小者3岁,最大者12岁,平均年龄(6.8±1.3)岁,其中3~5岁94例(18.8%),6~10岁175例(35.0%),11~12岁231例(46.2%)。500例结核感染患儿T-SPOT.TB试验的阳性率为72.0%,PPD试验的阳性率为61.6%,胸部CT检查的阳性率为52.8%。采用T-SPOT.TB试验诊断儿童结核感染的敏感度和特异度均明显高于PPD试验及胸部CT检查(P均<0.05)。结论:结核感染患儿中男性及学龄儿童的占比偏高。相较于PPD试验及胸部CT检查,T-SPOT.TB试验诊断儿童结核感染的敏感度和特异度均更高,但其检查费用较高且未纳入医保报销范畴,未在临床普及,因此PPD试验及胸部CT检查仍是目前临床上早期诊断儿童结核感染的重要方法。Objective:To investigate the epidemiology and early diagnosis of tuberculosis in children in Zunyi area.Methods:This study collected 500 children with tuberculosis infection in Zunyi region from July 2019 to July 2021,retrospectively analyzed their general data and clinical diagnosis and treatment data,summarized their clinical characteristics,and summarized the prevalence of tuberculosis infection in children in Zunyi region.At the same time,children with tuberculosis infection were taken as the tuberculosis infection group.A total of 500 healthy children were selected as the control group during the same period.T-SPOT.TB test,PPD test and chest CT examination were performed in both groups.Results:In terms of gender distribution,among the 500 children with tuberculosis infection,there were 298(59.6%)males and 202(40.4%)females,and the proportion of male children was significantly higher than that of female children(P<0.05).The average age was(6.8±1.3)years.There were 94 cases(18.8%)aged 3-5 years,175 cases(35.0%)aged 6-10 years,and 231 cases(46.2%)aged 11-12 years.The positive rate of T-SPOT.TB test,PPD test and chest CT examination was 72.0%,61.6%and 52.8%,respectively.The sensitivity and specificity of T-SPOT.TB test in the diagnosis of tuberculosis infection in children were significantly higher than those of PPD test and chest CT examination(all P<0.05).Conclusion:The proportion of male and school-age children in children with tuberculosis infection is high.Compared with PPD test and chest CT examination,T-SPOT.TB test has higher sensitivity and specificity in the diagnosis of tuberculosis infection in children,but its examination cost is high,and it is not included in the scope of medical insurance reimbursement,and it is not widely used in clinical practice.Therefore,PPD test and chest CT examination are still important methods for early diagnosis of tuberculosis infection in children.

关 键 词：儿童结核感染 流行病学调查 诊断方法 T-SPOT.TB试验 PPD试验 胸部CT检查 

分 类 号：R529.9[医药卫生—内科学]