2013-2016年大连市青少年结核病检出情况分析

Detection of tuberculosis among adolescents in Dalian from 2013 to 2016

目的近年来我国青少年结核病感染率显著增加。本研究分析2013-2016年大连市青少年结核病检出情况。方法选取2013-01-01-2016-12-31大连市结核病医院30757名青少年体检资料,用结核菌素(tuberculin pure protein derivative,PPD)试验、胸部X线检查、细针穿刺细胞学和组织病理学结核病切片检查筛查结核病患者。结果共确诊结核病患者364例,检出率为1.18%,其中男178例,检出率为0.95%,女186例,检出率为1.55%,χ~2=22.476,P<0.001。其中肺外结核142例(40.20%),肺结核179例(50.50%),肺结核合并肺外结核33例(9.30%);179例肺结核患者中96例(53.5%)患者存在渗透物和固相物质的症状,83例(46.5%)存在胸腔积液;142例肺外结核患者细针穿刺细胞学/组织病理学结核病切片结果阳性45例(31.6%),结核病或结核杆菌(tubercle bacillus,TB)阳性34例(23.9%),腺苷脱氨酶(adenosine deaminase,ADA)水平升高33例(23.2%),腹部超声异常29例(20.4%)。所有肺外结核患者中,胸膜积液、中枢神经系统(central nervous system,CNS)TB、浸染TB、腹部TB、淋巴腺炎TB、心包TB和骨骼TB病例数分别为39例(27.7%)、36例(25.5%)、29例(20.6%)、29例(20.6%)、4例(2.8%)、2例(1.4%)和2例(1.4%)。结论肺部疾病在结核病例中占较高比例。在各类结核病例中,胸膜积液结核和中枢神经系统结核是较为普遍的腹部结核,而淋巴腺炎较少见,且女性检出率高于男性。

OBJECTIVE In recent years,the infection rate of tuberculosis among adolescents in China has increased significantly.This study analyzes the prevalence of tuberculosis among adolescents in Dalian from 2013 to 2016.METHODS A totally of 364 adolescent tuberculosis patients admitted to Dalian Tuberculosis Hospital from January 1,2013 to December 31,2016 were selected for this study.Tuberculin pure protein derivative test,chest X-ray examination,fine needle aspiration cytology and histopathological tuberculosis section examination were used for analysis.RESULTS A total of 364 patients with tuberculosis were diagnosed,the detection rate was 1.18%,including 178 males,the detection rate was 0.95%,186 females,the detection rate was 1.55%,χ~2=22.476,P<0.001.Among them,142 cases(40.20%)of extrapulmonary tuberculosis,179 cases(50.50%)of tuberculosis,33 cases(9.30%)of tuberculosis with extrapulmonary tuberculosis;96 cases(53.5%)of 179 cases of tuberculosis had permeate and solid phase substances symptoms,83 cases(46.5%)had pleural effusion;142 cases of extrapulmonary tuberculosis patients with fine needle aspiration cytology/histopathology tuberculosis section results were positive in 45 cases(31.6%),tubercle bacillus(+)34 cases(23.9%).The adenosine deaminase level increased in 33 cases(23.2%),and abdominal ultrasound abnormalities in 29 cases(20.4%).Among all patients with extrapulmonary tuberculosis,the number of pleural effusions,central nervous system TB,TB,abdominal TB,lymphadenitis TB,pericardial TB,and bone TB were 39(27.7%),36(25.5%),29(20.6,%),29(20.6%),4(2.8%),2(1.4%)and 2(1.4%).CONCLUSIONS Pulmonary diseases accounted for a high proportion of tuberculosis cases.Among all types of tuberculosis cases,pleural effusion tuberculosis and central nervous system tuberculosis were more commonly seen,while lymphadenitis was less common,and the detection rate of women was higher than that of men.