基于两种方法筛查常州市高校学生结核潜伏感染结果比较  

Comparison of latent tuberculosis infection screening results among university students in Changzhou using two methods

作　　者：张兴[1] 冯彬 周婷钰 姜虹[3] 李晨[4] ZHANG Xing;FENG Bin;ZHOU Ting-yu;JIANG Hong;LI Chen(Changzhou Municipal Center for Disease Control and Prevention,Changzhou Jiangsu 21300,China;不详)

机构地区：[1]常州市疾病预防控制中心,江苏常州213000 [2]南京医科大学公共卫生学院 [3]常州市武进区疾病预防控制中心 [4]南京市疾病预防控制中心

出　　处：《江苏预防医学》2024年第3期320-323,共4页Jiangsu Journal of Preventive Medicine

基　　金：常州市科技项目(CE20215019)。

摘　　要：目的了解常州地区高校学生结核潜伏感染现状,比较结核分枝杆菌素释放试验(tuberculosis skin test,TST)和结核分枝杆菌特异性细胞免疫反应(QuantiFERON-TB Gold In-tube,QFT)检测2种方法一致性。方法2020年采用整群抽样方法,选取常州市两所高校共625名学生进行TST和QFT检测,并进行为期2年的结核病病例监测。结果625名学生中,筛查出结核潜伏感染118人,检出率为18.88%(95%CI:15.94%~21.82%);其中单TST检测阳性率为15.20%,单QFT检测阳性率为10.72%,双阳性率为7.04%。以TST硬结直径≥5 mm为阳性判断标准时,两种检测方法的一致性为中等(Kappa值=0.48,P<0.01);以≥10 mm、≥15mm为阳性判断标准时两种方法一致性均较差(Kappa值=0.33、0.21,P值均<0.01)。筛查出结核潜伏感染118名学生中,参与预防性服药39名(占33.05%)。2年随访确诊为活动性结核病3例,2年累计发病率为0.48%。结论建议在TST硬结直径≥10 mm学生中加做QFT试验,且对单纯TST强阳性或QFT阳性学生采取预防性服药措施,有结核病接触史学生应作为结核筛查和预防性服药重点人群。Objective To understand the current situation of latent tuberculosis infection(LTBI)among university students in Changzhou;to compare the consistency of two screening methods:the tuberculin skin test(TST)and the QuantiFERON-TB Gold In-Tube test(QFT).Methods In 2020,a cluster sampling method was used to select a total of 625 students from two universities in Changzhou for TST and QFT testing.Tuberculosis cases were monitored over a period of two years.Results Among the 625 students,118 were screened positive for LTBI,with a detection rate of 18.88%(95%CI:15.94%-21.82%).The positive rates for TST and QFT were 15.20%and 10.72%,respectively;the positive rate of both tests was 7.04%.When using a TST induration diameter of≥5 mm as the positive criterion,the consistency between the two methods was moderate(Kappa value=0.48,P<0.01).When using≥10 mm or≥15 mm as the positive criteria,the consistency was poor(Kappa values of 0.33 and 0.21,respectively,both P values<0.01).Among the 118 students screened positive for LTBI,39(33.05%)participated in preventive medication.During the two-year follow-up study,3 cases of active tuberculosis were confirmed,with a cumulative incidence rate of 0.48%.Conclusions It is recommended to perform QFT testing for students with a TST induration diameter of≥10 mm.The preventive medication should be conducted for students with strongly positive on TST or positive on QFT.Students with a history of tuberculosis contact should be prioritized for tuberculosis screening and preventive medication.

关 键 词：潜伏性结核感染 高校学生 TST QFT 发病率 

分 类 号：R521[医药卫生—内科学]