摘要
目的:评估本地区中小学生结核病流行病学状况。方法:用传统流行病学和分子流行病学方法。对125893名中、小学生进行PPD实验和X线检查;结核病人进行痰结核菌涂片和培养;对结核分枝杆菌分离株进行分子流行病学研究,用标准RFLP技术使用IS6110插入序列对结核分枝杆菌进行分型和成簇分析。结果:125893名中、小学生中(95.9%)接种过BCG。小学生1~4年级PPD阳性20963例,阳性率47.9%,其中强阳性17例;确定诊断结核感染3例、颈淋巴结结核4例,原发综合征和肺门淋巴结结核10例。小学5、6年级和中学生共X线异常阴影并确诊为肺结核48例。58例肺结核病人痰抗酸染色阳性15例(25.9%)、培养阳性42例(72.4%);患病率46.1/10万;涂阳患病率13.5/10万。42株结核分枝杆菌中,IS6110 RFLP分析23株(55%)成簇,拷贝相似性高;其余19株IS6110拷贝呈现多态性。最大簇包含3例病人。结论:本地区中、小学生结核病患病率较低;新近传播病例未形成较大成簇,近期可能无集团感染和暴发发生。
Objective: To evaluate the epidemiological state of tuberculosis of students and pupils in Longgang district using conventional and molecular epidemiological methods. Methods: In a general investigation of tuberculosis of 125 893 students and pupils in Longgang district from April to May in 2004, the tuberculin skin test (PPD) and chest radiology (X- ray) was made. Smear and culture of M tuberculosis for presumed tuberculosis patients. The standard restriction fragment length polymorphism (RFLP) technique together with the IS6110 insertion sequence was used to subtype Mtuberculosis. Results: It is 120 857 (95.9%) BCG-vaccinated people in 125 893 receiver. 20 963 people (47.9 % ) who were tuberculin skin test (PPD) positive in 43 682 pupils range of 1-4 grade, but only 17 pupils were strong reactive positive (〉15 mm). Latent tuberculosis was diagnosed infection in 3 children, cervical lymph nodes tuberculosis was diagnosed in 4 children, primary pulmonary TB and mediastinal lymph nodes TB was diagnosed in 10 children. 48 who were chest radiology positive in 82 211 pupils range of 5, 6 grade and students. All 58 tuberculosis patients were only 15 with (25.9%) positive staining and 42 (72.4%) had been cultured for acid-fast bacilli. The standardized incidence of active and bacteriological positive pulmonary tuberculosis were 46.1/100,000 and 13.5/100,000 respectively. Of the 42 patients who had isolates of M tuberculosis available, 23 (55 % ) showed molecular clustering with 13 (31% ) defined as being recently transmitted. Conclusion: The incidence of TB of students and pupils in Longgang district is lower. Recent transmitted TB accounts for a moderate proportion of tuberculosis cases.
出处
《现代预防医学》
CAS
北大核心
2006年第1期66-67,69,共3页
Modern Preventive Medicine