关键词: 结核, 肺/预防和控制, 体格检查, 病人预约和时间安排, 对比研究

Abstract: Objective  This study is to compare the TB patients detected by active health check and passive identification, including their geographical and clinical features, laboratory testing and to analyze the significance of active discovery in TB case detection in order to provide a basis for policy formulation.  Methods  We collected the health check information of 221383 people in part of “tuberculosis incidence and intervention pattern” study area (hereinafter referred to as “active discovery methods”)and 7625650 people information among which TB cases were detected by passive identification (hereinafter referred to as “passive discovery methods”). The data of patients detected by active discovery were from the project survey; of passive discovery were from the TB patients management system, out-patient medical records, registration of newly diagnosed patients. Using Excel software for database setting up and double entry, packages SPSS 17.0 for statistical analysis. We compared two groups of patients using a Chi-square test, with P<0.05 as a statistically significant difference. Results  A total of 444 cases of TB patients were detected by active case discovery with the detection rate of 200.56 per 100000. In contrast, 758 cases of TB patients were registered in TB institutions with the registration rates of 9.94 per 100000.In 444 patients with active discovery, the male∶female=2.70∶1; 358 cases elder than 60 years accounting for 80.63%. In 758 cases with passive discovery, male: female=1.86∶1; 300 cases elder than 60 years accounting for 39.58%. The gender and age distribution in active and passive discovery group are statistically different (χ²=5.430 and 203.090 for gender and age respectively, P both less than 0.05). For active discovery, 7.43%（33/444） were sputum smear-positive, lower than passive discovery of 39.31%(298/758). In active discovery patients, the lesions of 251 cases ranged in 1-2 lung fields, accounting for 56.53%;153 cases of 3-4 lung fields accounting for 34.46%;40 cases of 5-6 lung fields accounting for 9.01%.In passive discovery patients, the lesions of 508 cases ranged in one or two lung fields accounting for 67.02%;171 cases of 3-4 lung fields accounting for 22.56%;79 cases of 5-6 lung fields accounting for 10.42%;The difference is statistically significant in two groups(χ²=19.517,P<0.001). 6.53%（29/444） of active discovered patients had lung cavities, significantly lower than 20.84% (158/758) of passive discovered patients (χ²=43.661，P<0.001）. Conclusion  The illness of the patients detected by active discovery may not be light, but symptoms not obvious. The active discovery has an important value for early diagnosis of patients with tuberculosis.

Key words: Tuberculosis, pulmonary/prevention &, control, Physical examination, Appointments and schedules, Comparatitve study