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中国防痨杂志 ›› 2024, Vol. 46 ›› Issue (1): 40-44.doi: 10.19982/j.issn.1000-6621.20230215

• 论著 • 上一篇    下一篇

2020—2022年北京市大学和高中学段新生结核菌素皮肤试验反应特征分析

赵鑫1, 张亚楠1, 闫银锁1, 陶荔莹1, 李亚敏1, 许琰1, 高志东1(), 贺晓新2()   

  1. 1北京市疾病预防控制中心结核病预防控制所,北京 100035
    2北京市疾病预防控制中心,北京,100035
  • 收稿日期:2023-06-25 出版日期:2024-01-10 发布日期:2024-01-04
  • 通信作者: 贺晓新,Email:hexiaoxin@wjw.beijing.gov.cn;高志东,Email:guhu751029@126.com

Analysis of the characteristics of tuberculin skin test reactions among college and high school freshmen in Beijing from 2020 to 2022

Zhao Xin1, Zhang Yanan1, Yan Yinsuo1, Tao Liying1, Li Yamin1, Xu Yan1, Gao Zhidong1(), He Xiaoxin2()   

  1. 1Institute for Tuberculosis Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing 100035, China
    2Beijing Center for Disease Prevention and Control, Beijing 100035, China
  • Received:2023-06-25 Online:2024-01-10 Published:2024-01-04
  • Contact: He Xiaoxin,Email:hexiaoxin@wjw.beijing.gov.cn;Gao Zhidong,Email:guhu751029@126.com

摘要:

目的:了解2020—2022北京市大学和高中学段入学新生结核菌素皮肤试验(tuberculin skin test,TST)反应特征,为学校结核病防控及疫情处置工作提供依据。方法:利用“北京市新生肺结核筛查系统”及《大学新生PPD筛查登记表》报表,建立北京市大学和高中学段入学新生结核病筛查数据库,选取2020—2022年进行TST检测并完成复验的高中、大学录取新生为调查对象,共纳入292486名;其中,选取2020—2021年进行监测的大学录取新生为调查对象,共计159915名;选取2021—2022年高中录取新生作为调查对象,共计132571名。调查对象均进行TST且完成复验。结果:调查对象TST硬结平均直径≥5mm者占15.57%(45545/292486)、硬结平均直径≥10mm者占7.38%(21582/292486),硬结平均直径≥15mm者占2.94%(8599/292486)。在大学学段新生中,以硬结平均直径≥10mm为阳性标准,女生阳性率(9.27%,6678/72038)明显高于男生(8.93%,7836/87708),差异有统计学意义(χ2=5.403,P=0.020);西部、中部、东部生源阳性率分别为10.95%(3757/34297)、10.15%(3642/35897)、7.69%(6659/86580),差异有统计学意义(χ2=399.682,P<0.001);以硬结平均直径≥5mm为阳性标准,男生阳性率(17.56%,15403/87708)明显高于女生(17.03%,12269/72038),差异有统计学意义(χ2=7.769,P=0.005)。在高中学段新生中,以硬结平均直径≥10mm为阳性标准,女生阳性率(5.62%,3539/63018)明显高于男生(5.06%,3517/69553),差异有统计学意义(χ2=20.523,P<0.001);有肺结核可疑症状者的阳性率(10.63%,17/160)明显高于无肺结核可疑症状者(5.32%,7039/132408),差异有统计学意义(χ2=8.938,P=0.003);有肺结核患者密切接触史者的阳性率(11.48%,14/122)高于无密切接触史者(4.76%,5733/120501),差异有统计学意义(χ2=12.122,P<0.001);城六区新生阳性率(5.70%,4373/76713)高于非城六区新生(4.80%,2683/55858),差异有统计学意义(χ2=51.635,P<0.001)。大学新生总体肺结核检出率为33.96/10万(129/379810),明显高于高中阶段新生的15.09/10万(20/132571),差异有统计学意义(χ2=12.047,P=0.001)。结论:北京市大学学段新生TST阳性率和肺结核检出率均高于高中学段新生,女生、西部生源地、肺结核可疑症状者、肺结核患者密切接触者的结核分枝杆菌感染率相对较高,提示应加强北京市新生入学肺结核筛查,以做好学校结核病防控工作。

关键词: 结核,肺, 皮肤试验, 学生

Abstract:

Objective: To investigate the characteristics of tuberculin skin test (TST) reaction of freshmen enrolled in universities and high schools in Beijing from 2020 to 2022, and to provide basis for school tuberculosis prevention and control and epidemic situation. Methods: Based on the “Beijing New Student Tuberculosis Screening System” and the University New Student PPD Screening Registration Form report, the database of tuberculosis screening for new students enrolled in universities and high schools in Beijing was established, and 292486 new students enrolled in high schools and universities who had completed TST testing and retesting from 2020 to 2022 were selected as the survey objects. Among them, 159915 were newly admitted university students who underwent monitoring from 2020 to 2021, and 132571 were newly admitted high school students from 2021-2022. All the survey subjects underwent TST and completed retesting. Results: Of the subjects, 15.57% (45545/292486) had an average diameter of TST hard nodules ≥5 mm, 7.38% (21582/292486) had an average diameter of hard nodules ≥10 mm, and 2.94% (8599/292486) had an average diameter of hard nodules ≥15 mm. Among college freshmen, the positive rate in female students (9.27%, 6678/72038) was significantly higher than that in male students (8.93%, 7836/87708) based on the average diameter of hard nodules ≥10 mm, with a statistically significant difference (χ2=5.403, P=0.020). The positive rates of students from the western, central, and eastern regions were 10.95% (3757/34297), 10.15% (3642/35897), and 7.69% (6659/86580), respectively, with statistically significant differences (χ2=399.682, P<0.001). Taking the average diameter of hard nodules ≥5 mm as the positive standard, the positive rate of male students (17.56%, 15403/87708) was significantly higher than that of female students (17.03%, 12269/72038; χ2=7.769, P=0.005). Among high school freshmen, the positive rate of female students (5.62%, 3539/63018) was significantly higher than that of male students (5.06%, 3517/69553) based on the average diameter of hard nodules≥10 mm, with a statistically significant difference (χ2=20.523, P<0.001). The positive rate of patients with suspected symptoms of pulmonary tuberculosis was significantly higher than those without suspected symptoms of pulmonary tuberculosis (10.63% (17/160) vs. 5.32% (7039/132408), χ2=8.938, P=0.003). The positive rate of patients with close contact history of pulmonary tuberculosis (11.48%, 14/122) was higher than those without close contact history (4.76%, 5733/120501), and the difference was statistically significant (χ2=12.122, P<0.001). The positive rate of new students in urban six districts (5.70%, 4373/76713) was higher than that in non-urban six districts (4.80%, 2683/55858), and the difference was statistically significant (χ2=51.635, P<0.001). The overall tuberculosis detection rate among college freshmen was 33.96/100000 (129/379810), significantly higher than that of high school freshmen (15.09/100000 (20/132571)), with a statistically significant difference (χ2=12.047, P=0.001). Conclusion: The positive rate of TST and the detection rate of pulmonary tuberculosis of freshmen in Beijing’s university are higher than those of freshmen in senior high school. The infection rate of mycobacterium tuberculosis in female students, western student origin, students with suspected symptoms of pulmonary tuberculosis, and close contacts of pulmonary tuberculosis patients is relatively high, which suggests that the screening of pulmonary tuberculosis of freshmen in Beijing should be strengthened to improve the prevention and control of tuberculosis in schools.

Key words: Tuberculosis, pulmonary, Skin tests, Students

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