2020—2022年上海市徐汇区学校结核病密切接触者潜伏感染现状  

Latent tuberculosis infection and screening method among close contacts in schools in Xuhui District,Shanghai from 2020 to 2022

作　　者：张赛男[1] 杨美霞[1] 蔡晓峰[1] 许缃[1] 张轶[1] ZHANG Sainan;YANG Meixia;CAI Xiaofeng;XU Xiang;ZHANG Yi(Xuhui District Center for Disease Control and Prevention,Shanghai 200237,China)

机构地区：[1]上海市徐汇区疾病预防控制中心,上海200237

出　　处：《上海预防医学》2023年第12期1223-1226,共4页Shanghai Journal of Preventive Medicine

基　　金：上海市徐汇区科学技术委员会、上海市徐汇区卫生健康委员会医学科研课题(SHXH201946);上海市卫生和计划生育委员会课题(201840151)。

摘　　要：【目的】了解徐汇区学校结核病密切接触者结核潜伏感染(LTBI)情况,探究结核菌素试验(TST)+γ干扰素释放试验(IGRA)两步法在学校结核病筛查中的可行性,探索符合徐汇区学校结核病的筛查策略。【方法】连续选取徐汇区2020—2022年徐汇区学校肺结核病例的密切接触者作为研究对象,开展症状、TST、胸部X线、IGRA等筛查,收集指示病例病原学结果、年级信息,收集研究对象性别、年龄、与指示病例关系信息。【结果】最终纳入32例学校肺结核病例的615名密切接触者,609名密切接触者完成结核感染检测,其中609名学生完成TST检测,153名TST阳性者完成IGRA检测,最终LTBI感染率为4.6%,肺结核检出率163/10万。与指示病例的关系为LTBI的影响因素。TST强阳性(硬结平均直径≥15 mm)的密切接触者IGRA筛查阳性率较TST中度阳性者(硬结平均直径为10~<15 mm)高(χ2=14.41,P<0.05)。【结论】徐汇区学校结核病密切接触者LTBI情况依然较为严峻,TST+IGRA两步法可以协助准确诊断LTBI和肺结核病例。[Objective]To investigate the latent tuberculosis infection(LTBI)of close contacts in schools of Xuhui District,and to explore the tuberculin skin test(TST)-interferon-γrelease assay(IGRA)two-step method in order to discover the screening strategy of tuberculosis in Xuhui District.[Methods]Close contacts of tuberculosis in schools of Xuhui District from 2020 to 2022 were selected as research subjects.Screening was conducted using symptom questionnaire,TST,chest X-rays,IGRA,and the information including the etiological results and grade of the index cases,as well as gender,age,and relationship with the index cases of the research subjects were collected.[Results]Totally 615 close contacts of 32 tuberculosis cases occurred in the schools were finally included.Of the 609 close contacts who completed tuberculosis infection screening and underwent TST testing,153 TST(+)individuals underwent IGRA testing.The final LTBI rate was 4.6%,and the pulmonary tuberculosis detection rate was 163 per 100000.The relationship with the index cases was an influencing factor for LTBI.The IGRA positivity rate was higher among close contacts with TST≥15 mm than among those with 10 mm≤TST<15 mm(χ2=14.41,P<0.05).[Conclusion]The latent tuberculosis infection among close contacts of school tuberculosis cases in Xuhui District remains serious.TST-IGRA two-step method can assist in the accurate diagnosis of LTBI and pulmonary tuberculosis cases.

关 键 词：结核菌素试验 Γ干扰素释放试验 学校 结核潜伏感染 密切接触者 

分 类 号：R179[医药卫生—妇幼卫生保健]