某高校1例肺结核患者接触者的筛查结果分析  

PPD test results of close and general contacts of a patient with pulmonary tuberculosis

作　　者：贺晨耘 李艳华 宁洁 夏春燕[1] HE Chenyun;LI Yanhua;NING Jie;XIA Chunyan(Changzhou University Health Institute,Changzhou 213000,Jiangsu,China)

机构地区：[1]常州大学卫生所,江苏常州213000

出　　处：《中国校医》2024年第7期535-537,541,共4页Chinese Journal of School Doctor

摘　　要：目的 探索痰菌阳性结核患者不同接触程度的学生筛查结果,特别是结核菌素(PPD)试验的差异,为学校肺结核防治工作提供参考依据。方法 回顾性分析比较2022年6月江苏省某大学发生肺结核疫情的密切接触者、同楼层一般接触者、非同楼层一般接触者和无接触者的PPD试验、胸片、症状筛查结果,共443人。3个月后对PPD试验结果为阴性的密切接触者和一般接触者共266人进行了二次筛查,旨在评估不同接触程度学生PPD结果的区别。结果 首次筛查密切接触者PPD强阳性率为31.3%,同楼层一般接触者PPD强阳性率为14.0%,非同楼层一般接触者PPD强阳性率为5.8%,此次无接触者即阴性对照组PPD强阳性率为5.1%。密切接触者与所有一般接触者的PPD强阳性率差异有统计学意义(χ^(2)=14.719,P=0.001);所有一般接触者与阴性对照组的PPD强阳性率差异有统计学意义(χ^(2)=8.239,P=0.016);同楼层一般接触者与阴性对照组的PPD强阳性率差异有统计学意义(χ^(2)=10.104,P=0.006);非同楼层一般接触者和阴性对照组的PPD强阳性率差异无统计学意义(χ^(2)=3.773,P=0.152)。随访3个月后,密切接触者和一般接触者PPD试验结果阴性转阳性人数均为0。本次筛查中未发现肺结核患者。结论 对于结核病发病时间较长的学生,除进行密切接触者的PPD皮试筛查外,有必要对其同楼层一般接触者进行PPD皮试筛查。Objective This study explored the differences in PPD test results among students with different levelsof exposure to sputum positive patients with tuberculosis,to provide a reference for school tuberculosis prevention andcontrol.Methods A retrospective analysis was conducted to compare the PPD test results of 443 close contacts,generalcontacts on the same floor,non-contacts on the same floor,and non-contact individuals who had a tuberculosis outbreak at auniversity in Jiangsu Province in June 2022.Close contacts and general contacts on the same floor who had a negative PPDtest result for the first time were followed up for 3 months.The PPD test findings were reviewed after 3 months to evaluate thedifference in results between general contacts on the same floor and other levels of contact.Results After two screenings,the strong positive rate of PPD among close contacts was 31.3%,whereas that among general contacts on the same floor was14.0%.The strong positive rate of PPD among general contacts on different floors was 5.8%,and that among non-contacts inthe negative control group was 5.1%.The strong positive rate of PPD among close contacts was significantly higher than thatamong all general contacts(χ~2=14.719,P=0.001).The strong positive rate of PPD among all general contacts was significant-ly higher than that in the negative control group(χ~2=8.239,P=0.016).The number of general contacts on the same floor wassignificantly higher than that in the negative control group(χ~2=10.104,P=0.006).No statistically significant difference wasobserved between general contacts on different floors and the negative control group(χ~2=3.773,P=0.152).After a 3-monthfollow-up,the number of PPD test negative to positive individuals among both close contacts and general contacts was zero.Conclusion For students with long-term tuberculosis,PPD skin test screening is necessary among close contacts and gener-al contacts on the same floor.

关 键 词：肺结核 结核菌素试验 学生 接触者追踪 

分 类 号：R512[医药卫生—内科学]