活动性肺结核患者家庭内密切接触者结核感染情况调查

Screening of tuberculosis infection among family close contacts of patients with active pulmonary tuberculosis

目的调查活动性肺结核患者家庭内密切接触者感染结核情况,为制定结核感染防控措施提供依据。方法选取2018年6月—2023年6月于西部战区总医院确诊的188例活动性肺结核患者的家庭内密切接触者(接触时间均大于3个月)作为研究对象,采用结核菌素纯蛋白衍化物试验(PPD)和胸部X线检查筛查结核感染,分析不同年龄、性别、家庭关系、户籍及是否伴有可疑肺结核症状等与活动性肺结核检出率、PPD阳性率之间的关系。结果共纳入188例确诊活动性肺结核患者的家庭内密切接触者405人,检出活动性肺结核9例(2.22%);208例接受PPD试验,其中阳性90例(43.27%),强阳性31例(14.90%)。年龄41~60岁和>60岁的家庭内密切接触者的活动性肺结核检出率高于<15和15~40岁(P<0.05),且41~60岁的家庭内密切接触者PPD阳性率高于其他年龄组(P<0.05)。不同性别的家庭内密切接触者活动性肺结核检出率、PPD阳性率差异无统计学意义(P>0.05)。父母的活动性肺结核检出率高于子女、配偶及其他关系人群(P<0.05),且不同家庭关系接触者的PPD阳性率差异无统计学意义(P>0.05)。外地户籍、伴有可疑肺结核症状的家庭内密切接触者活动性肺结核检出率和PPD阳性率高于本地户籍和无可疑症状者(P<0.05)。结论肺结核患者家庭内密切接触者活动性肺结核发生率与结核潜伏感染风险较高,其中40岁以上、外地户籍、家庭关系为父母及伴有可疑肺结核症状的家庭内密切接触者是高危群体。

Objective To investigate tuberculosis infection among family close contacts of patients with active pulmonary tuberculosis,so as to provide basis for developing tuberculosis infection prevention and control measures.Methods The family close contacts(longer than 3 months of contact)of 188 patients with active pulmonary tuberculosis who were diagnosed at Western Theater General Hospital from June 2018 to June 2023 were selected as the research subjects.Tuberculin purified protein derivative(PPD)test and chest X-ray examination were used to screen tuberculosis infection.The relationships of age,gender,family relationships,household,suspicious symptoms of pulmonary tuberculosis,the detection rate of active pulmonary tuberculosis and PPD positive rate were analyzed.Results A total of 405 persons of family close contacts of 188 patients diagnosed with active pulmonary tuberculosis were included in this study,and 9 cases(2.22%)of active pulmonary tuberculosis were detected positive.A total of 208 individuals received PPD test,including 90(43.27%)positive and 31(14.90%)strongly positive cases.The detection positive rate of active pulmonary tuberculosis in family close contacts aged 41-60 and over 60 years old was higher than that in those under 15 years old and aged 15-40(P<0.05).PPD positive rate in family close contacts aged 41-60 was higher than that in other age groups(P<0.05).There was no significant difference in the positive rate of active tuberculosis or PPD positive rate between family close contacts of different gender(P>0.05).The positive rate of active pulmonary tuberculosis was higher among parents than children,spouses and other close contacts(P<0.05),but there was no significant difference in PPD positive rate among different family relationships(P>0.05).The detection rate of active tuberculosis and PPD among close contacts from other regions and with suspected symptoms of pulmonary tuberculosis were higher than those among local close contacts and those without suspected symptoms(P<0.05).Conclusion The incidence of active pulmonary tuberculosis and the risk of latent tuberculosis infection were relatively higher among family close contacts of patients with pulmonary tuberculosis.Those aged over 40,from other regions,parents and family close contacts with suspected symptoms of pulmonary tuberculosis were high risk groups.