人群主动筛查策略助力结核病防控  

Population-based active screening strategy contributes to the prevention and control of tuberculosis

作　　者：丁丞[1] 嵇仲康 郑琳[1] 金秀媛[1] 阮冰[1] 张颖 李兰娟[1,2] 徐凯进 DING Cheng;JI Zhongkang;ZHENG Lin;JIN Xiuyuan;RUAN Bing;ZHANG Ying;LI Lanjuan;XU Kaijin(The First Affiliated Hospital,Zhejiang University School of Medicine,State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,National Clinical Research Center for Infectious Diseases,National Medical Center for Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,Hangzhou 310003,China;Jinan Microecological Biomedicine Shandong Laboratory,Jinan 250117,China)

机构地区：[1]浙江大学医学院附属第一医院、传染病诊治国家重点实验室国家感染性疾病临床医学研究中心、国家传染病医学中心、感染性疾病诊治协同创新中心,浙江杭州310003 [2]济南微生态生物医学山东省实验室,山东济南250117

出　　处：《浙江大学学报（医学版）》2022年第6期669-678,共10页Journal of Zhejiang University(Medical Sciences)

基　　金：国家重点研发计划(2021YFC2301800);国家科技重大专项(2017ZX10105001,2018ZX10715014)。

摘　　要：近年来,结核病人群防治取得了显著成效,但包括中国在内的许多国家和地区存在诊断率偏低、漏诊率较高和延误诊断等问题。中国结核病患者发现模式经历从“X线检查、主动发现”到“因症就诊、被动发现”变化,当前以因症就诊为主、主动筛查和健康体检等多途径联合为辅。人群主动筛查有助于识别出早期无症状和未就诊病例。随着分子生物学及人工智能辅助诊断技术发展,大规模人群主动筛查手段有了更多选择。尽管人群主动筛查策略实施成本较高,但其在社会效益层面具有较大价值,在特殊人群中开展主动筛查可获得更好的效益。结核病人群主动筛查是疾病防治的重要组成部分,建议各地区结合实际情况优化相关措施,最终保障筛查策略有助于疾病的人群防控。Despite the achievements obtained worldwide in the control of tuberculosis in recent years,many countries and regions including China still face challenges such as low diagnosis rate,high missed diagnosis rate,and delayed diagnosis of the disease.The discovery strategy of tuberculosis in China has changed from“active discovery by X-ray examination”to“passive discovery by self-referral due to symptoms”,and currently the approach is integrated involving self-referral due to symptoms,active screening,and physical examination.Active screening could help to identify early asymptomatic and untreated cases.With the development of molecular biology and artificial intelligence-assisted diagnosis technology,there are more options for active screening among the large-scale populations.Although the implementation cost of a population-based active screening strategy is high,it has great value in social benefits,and active screening in special populations can obtain better benefits.Active screening of tuberculosis is an important component of the disease control.It is suggested that active screening strategies should be optimized according to the specific conditions of the regions to ultimately ensure the benefit of the tuberculosis control.

关 键 词：结核病 主动筛查 策略 人群 疾病防控 综述 

分 类 号：R521[医药卫生—内科学]