菌阳肺结核患者密切接触者的感染筛查、预防性治疗及发病情况研究

Study on Infection Screening, Preventive Treatment and Incidence of Close Contactsof Smear-positive Pulmonary Tuberculosis Patients

目的研究菌阳肺结核患者密切接触者的感染筛查、预防性治疗及发病情况。方法以2021年2月-2023年2月赤水市人民医院确认的120例菌阳肺结核患者密切接触者为研究对象,开展结核菌素(PPD)试验筛查,统计其感染筛查结果,对其预防性治疗及发病情况进行随访调查,分析不同治疗时间密接者的感染结局。结果本次PPD筛查结果中,阴性率为22.50%,阳性率为56.67%,强阳性率为20.83%,总阳性率77.50%;其中,男性密接者的总阳性率高于女性密接者(χ^(2)=4.004,P=0.045),≥50岁密接者的总阳性率高于<50岁密接者(χ^(2)=4.588,P=0.032)。PPD阳性与强阳性密接者中,接受预防性治疗者的活动性结核病发生率小于未接受预防性治疗者(P<0.05),且预防性治疗时间≥6个月的密接者结核分枝杆菌(MTB)转阴率高于预防性治疗时间<6个月的密接者(P<0.05)。结论菌阳肺结核患者的密切接触者存在较高MTB感染风险,开展预防性治疗可降低其结核病发病概率,其治疗时长可影响MTB的转阴效果。

Objective To study the infection screening,preventive treatment and incidence of close contacts of smear-positive pulmonary tuberculosis patients.Methods From February 2021 to February 2023,120 close contacts of patients with bacterial positive pulmonary tuberculosis confirmed by Chishui People's Hospital were selected as the research objects.PPD test screening was carried out,and the results of infection screening were counted.The preventive treatment and incidence were followed up,and the infection outcomes of close contacts at different treatment time were analyzed.Results In the PPD screening results,the negative rate was 22.50%,the positive rate was 56.67%,the strong positive rate was 20.83%,and the total positive rate was 77.50%.Among them,the total positive rate of male close contacts was higher than that of female close contacts(χ^(2)=4.004,P=0.045),and the total positive rate of≥50 years old close contacts was higher than that of<50 years old close contacts(χ^(2)=4.588,P=0.032).Among PPD positive and strong positive close contacts,the incidence of active tuberculosis in patients receiving preventive treatment was lower than that in patients not receiving preventive treatment(P<0.05),and the negative conversion rate of Mycobacterium tuberculosis(MTB)in close contacts with preventive treatment time≥6 months was higher than that in close contacts with preventive treatment time<6 months(P<0.05).Conclusion The close contacts of smear-positive pulmonary tuberculosis patients have a high risk of MTB infection.Preventive treatment can reduce the incidence of tuberculosis,and the duration of treatment can affect the negative conversion effect of MTB.