肺结核密切接触学生结核菌素皮肤试验结果分析  

Tuberculin skin test results among student close contacts with pulmonary tuberculosis

作　　者：孙佳美[1] 卢巧玲[1] 高华强[1] 杨作凯[1] 徐来潮 SUN Jiamei;LU Qiaoling;GAO Huaqiang;YANG Zuokai;XU Laichao(Shaoxing Center for Disease Control and Prevention,Shaoxing,Zhejiang 312075,China)

机构地区：[1]绍兴市疾病预防控制中心,浙江绍兴312075

出　　处：《预防医学》2025年第3期243-247,共5页China Preventive Medicine Journal

基　　金：浙江省疾病预防控制科技计划项目(2025JK298);全省传染病疫苗与预防控制研究重点实验室开放基金资助(2024KF06)。

摘　　要：目的了解肺结核密切接触学生结核菌素皮肤试验(TST)结果及TST阳性的影响因素,为学生肺结核防控提供依据。方法选择2016年10月—2023年12月浙江省绍兴市越城区≥15岁的肺结核密切接触学生为研究对象,通过问卷调查和TST收集人口学信息、接触史和TST结果等资料;采用多因素logistic回归模型分析肺结核密切接触学生TST阳性的影响因素。结果调查肺结核密切接触学生5507人,其中男生2982人,女生2525人,男女比为1.18∶1。年龄为(19.10±1.71)岁。中专学生397人,占7.21%;高中学生766人,占13.91%;大专学生2556人,占46.41%;大学及以上学生1788人,占32.47%。TST阳性958例,阳性率为17.40%;一般阳性率、中度阳性率和强阳性率分别为10.53%、4.98%和1.89%。多因素logistic回归分析结果显示,高中(OR=1.473,95%CI:1.009~2.152)或大专(OR=1.467,95%CI:1.074~2.005)、暴露至筛查间隔≥46 d(46~<61 d,OR=2.043,95%CI:1.478~2.826;≥61 d,OR=1.291,95%CI:1.018~1.637)的肺结核密切接触学生TST阳性风险较高;肺结核密切接触女生(OR=0.753,95%CI:0.649~0.873)TST阳性风险较低。结论肺结核密切接触学生TST阳性率较高,性别、学校类型、暴露至筛查间隔是肺结核密切接触学生TST阳性的影响因素。Objective To investigate the status of tuberculin skin test(TST)results and the influencing factors among student close contacts with pulmonary tuberculosis,so as to provide the evidence for developing prevention and control strategies for pulmonary tuberculosis among students.Methods The students aged 15 years and above who had close contact with pulmonary tuberculosis cases in Yuecheng District,Shaoxing City,Zhejiang Province,from October 2016 to December 2023 were recruited and investigated using questionnaires and TST to collect demographic information,contact history,and TST results.The influencing factors for TST positivity among student close contacts with pulmonary tuberculosis were analyzed using a multivariable logistic regression model.Results A total of 5507 student close contacts were investigated,including 2982 males and 2525 females,with a male-to-female ratio of 1.18∶1.The mean age was(19.10±1.71)years.Among them,397(7.21%)were technical secondary school students,766(13.91%)were senior high school students,2556(46.41%)were junior college students,and 1788(32.47%)were college students or above.A total of 958 students tested positive for TST,with a positivity rate of 17.40%.The rates of general positivity,moderate positivity,and strong positivity were 10.53%,4.98% and 1.89%,respectively.Multivariable logistic regression analysis showed that senior high school students(OR=1.473,95%CI:1.009-2.152)and junior college students(OR=1.467,95%CI:1.074-2.005),as well as those with an exposure-to-screening interval of≥46 days(46-<61 days,OR=2.043,95%CI:1.478-2.826;≥61 days,OR=1.291,95%CI:1.018-1.637)had a higher risk of TST positivity.Female student close contacts had a lower risk of TST positivity(OR=0.753,95%CI:0.649-0.873).Conclusion The TST positivity rate was relatively high,and gender,school type,and exposure-to-screening interval were influencing factors for TST positivity among student close contacts with pulmonary tuberculosis.

关 键 词：肺结核 密切接触者 学生 结核菌素皮肤试验 影响因素 

分 类 号：R521[医药卫生—内科学]