2021年宁波市初高中新生结核菌素皮肤试验结果分析  

Tuberculin skin test results among new middle and high school students in Ningbo in 2021

作　　者：林相[1] 于梅[1] 贺天锋[1] 车洋[1] 林律[1] 陈同[1] LIN Xiang;YU Mei;HE Tian-feng;CHE Yang;LIN Lyu;CHEN Tong(Ningbo Center for Disease Control and Prevention,Ningbo,Zhejiang 315010,China)

机构地区：[1]宁波市疾病预防控制中心,浙江宁波315010

出　　处：《中国预防医学杂志》2023年第2期135-138,共4页Chinese Preventive Medicine

基　　金：浙江省医药卫生科技计划(2022KY1189)。

摘　　要：目的 分析2021年宁波市初高中新生结核菌素皮肤(purified protein derivatives,PPD)试验筛查结果,为完善学校结核病防控策略提供科学依据。方法 对宁波市2021年秋季入学的高中及寄宿制初中新生进行问卷调查,对无PPD试验禁忌证者采用孟都氏法进行初筛,PPD试验强阳者再行胸部X线检查。分析比较新生的结核分枝杆菌(Mycobacterium tuberculosis,MTB)感染率与患者检出情况。结果 2021年宁波市初高中新生PPD试验平均筛查率94.63%,平均禁忌证率3.01%。MTB感染率4.96%,PPD试验强阳性率1.45%,且均存在卡介菌纯蛋白衍生物(purified protein derivative of BCG,BCG-PPD)试剂使用地区高于结核菌素纯蛋白衍生物(purified protein derivative of TB,TB-PPD)使用地区,女生高于男生,高中高于初中的规律,差异有统计学意义(均P<0.01)。采用PPD试验筛查方法共发现16例学生肺结核患者,占宁波市全年16岁以下学生患者的38.10%,不同试剂患者发现率差异无统计学意义(P=0.70)。结论 采用PPD试验进行初高中肺结核筛查行之有效,各地应严格落实《规范》要求,建立新生入学肺结核筛查长效机制。Objective To analyze tuberculin(pure protein derivatives, PPD) skin test results among new students in middle and high schools in Ningbo in 2021, and to provide scientific evidence for improving the strategy of TB prevention and control in schools. Methods A questionnaire survey was conducted among new students who were admitted to high schools and boarding junior high schools in the fall of 2021. Students free of test contraindications received PPD skin test through Mendu′s method, and those with strong positive PPD test were given X-ray chest examination. Mycobacterium tuberculosis(MTB) infections were determined and analyzed. Results In 2021, the average screening rate of PPD test among new students was 94. 63%, and the average contraindication rate was 3. 01%. The strong positive PPD test rate was 1. 45% and the overall MTB infection rate was 4. 96%, which was higher among students screened with BCG-PPD compared to those with TB-PPD, and was higher in girls than in boys, among students in high schools than those in junior high schools, the differences were statistically significant(all P<0. 01). Using PPD screening test, 16 students with pulmonary TB were determined, accounting for 38. 10% of student cases under 16 in Ningbo. There was no difference in patient discovery rate between the two reagents(P=0. 70). Conclusions PPD test screening is effective for pulmonary TB detection among new students in middle and high schools. Therefore, it is necessary to establish a long-term mechanism for pulmonary TB screening among new students.

关 键 词：结核菌素皮肤试验 学生 筛查 

分 类 号：R521[医药卫生—内科学]