四川某高中学生结核菌素皮肤试验筛查及随访分析  

Tuberculin Skin Test and Follow-up Analysis in a High School in Sichuan

作　　者：蒋铭航 李华 虞旭东 张理宏 宋学金 陈勇 黄富礼 JIANG Ming-hang;LI Hua;YU Xu-dong;ZHANG Li-hong;SONG Xue-jin;CHEN Yong;HUANG Fu-li(Department of Infectious Diseases,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Tuberculosis,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Laboratory of Infection and Immunology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Naxi District Center for Disease Control and Prevention,Luzhou City,Luzhou 646300,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院感染科,四川泸州646000 [2]西南医科大学附属医院结核病科,四川泸州646000 [3]西南医科大学附属医院感染与免疫实验室,四川泸州646000 [4]泸州市纳溪区疾病预防控制中心,四川泸州646000

出　　处：《罕少疾病杂志》2025年第4期44-46,共3页Journal of Rare and Uncommon Diseases

基　　金：省科技厅HIV感染者结核早期预警体系与规范化平台建设(2020YFS0514);国家“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十三五”课题(2018ZX10725509)。

摘　　要：目的通过分析结核暴露后,学生结核菌素皮肤试验结果及结核发病随访变化情况,为学校学生结核暴露后防控提供理论依据。方法收集四川某高中高一2018年1月和2018年6月两次共1004例结核密切接触者的结核菌素皮肤实验筛查结果,进行统计分析;同时随访活动性结核发病情况。结果第一次筛查678人,筛查出活动性肺结核患者2人(含指示病例),潜伏结核感染者22人,PPD强阳性率、中等阳性率分别为1.03%、2.21%;第二次筛查326人,筛查出肺结核患者2人,潜伏结核感染者50人,PPD强阳性率、中等阳性率分别为6.75%、8.90%。接受两次筛查的112人中,暴露于指示病例的同班级学生,第一次和第二次筛查的阳性率分别为12.50%、90.00%,截至到2022年12月,潜伏结核感染者中陆续6人患肺结核(8.3%)。结论学生中的活动性肺结核短期内即可导致与同班密切接触的其他同学PPD试验阳性率明显升高;结核暴露后五年发病率高达8.3%。应早期筛选出活动性肺结核学生并及时隔离以保护健康学生,从而避免学校结核疫情的发生。Objective By analyzing the results of tuberculin skin tests and the changes in tuberculosis incidence among students after exposure to tuberculosis,this study aims to provide a theoretical basis for the prevention and control of tuberculosis exposure in school students.Methods The tuberculin skin test screening results of 1004 close contacts of tuberculosis from a high school in Sichuan,collected in January and June 2018,were statistically analyzed.At the same time,the incidence of active tuberculosis was followed up.Results In the first screening,678 people were tested,and 2 active pulmonary tuberculosis patients(including the index case)and 22 latent tuberculosis infected individuals were identified.The rates of strong and moderate positive PPD reactions were 1.03%and 2.21%,respectively.In the second screening,326 people were tested,and 2 pulmonary tuberculosis patients and 50 latent tuberculosis infected individuals were identified.The rates of strong and moderate positive PPD reactions were 6.75%and 8.90%,respectively.Among the 112 people who underwent both screenings,those exposed to the index case in the same class had positive rates of 12.50%and 90.00%in the first and second screenings,respectively.By December 2022,6 out of the latent tuberculosis infected individuals had developed pulmonary tuberculosis(8.3%).Conclusion Active pulmonary tuberculosis among students can lead to a significant increase in the positive rate of PPD tests among other closely exposed classmates within a short period.The incidence rate of tuberculosis after exposure can reach as high as 8.3%within five years.It is essential to screen out students with active pulmonary tuberculosis early and isolate them in a timely manner to protect healthy students and prevent the outbreak of tuberculosis in schools.

关 键 词：学生 结核 结核菌素皮肤试验 

分 类 号：R52[医药卫生—内科学]