军队停止卡介苗接种策略的综合性评价

The Evaluation of Stopping BCG Vaccination Strategy in Army

[目的 ]了解部队卡介苗接种现况及效果 ,评价停止卡介苗接种策略的可行性。 [方法 ]采用卡痕检查、抗体测定、病例对照研究和发病率比较等综合分析。 [结果 ]老兵卡痕率和结核菌素阳性率均高于新兵 (P <0 0 1) ,新兵入伍前卡介苗未初种亦未自然感染者约占 2 0 % ;病例组卡痕率小于对照组 ,比数比 (OR )为 0 42 ,95 %CI为 0 2 3～ 0 76;卡介苗接种后抗 PPD阳性率高于接种前 (P <0 0 1) ,但接种后结核菌素试验阴性与阳性者抗体水平无明显差异 ;停止卡介苗接种 3年 ,肺结核发病率下降约 5 0 %。 [结论 ]卡介苗预防成人结核病仍具有一定效果 。

Objective\]To investigate the situation and effect of BCG vaccination and evaluate the feasibility of stopping BCG vaccination strategy in army.\The scar examine, antibody detection, case control study and compare of TB incidence were used for the study.\The scar rate and PPD positive rate among veteran were significantly higher than that among recruits (P<0 01). The recruits without BCG vaccination but nature infection of TB was about 20%. The scar rate of controls was significantly lower than that in cases (OR = 0.42,95% CI0 23～0 76). The positive rate of PPD antibody after BCG vaccination was higher than that before BCG vaccination (P<0 01). But the antibody level between positive and negative of old TB test was no obvious difference. Stopping BCG vaccination three years later, the incidence of TB declined about 50%.\[Conclusions\]Although prevention of TB using BCG among adult was effective it may be not suitable as main methods to prevent and control TB among recruits.