2008—2013年西安财经学院大学生肺结核患者发现效果分析

Analysis of TB case-finding among students in Xi＇ An University of Finance and Economics during 2008-- 2013

目的分析6年来西安财经学院大学生肺结核患者发现效果。方法以2008-2013年各年度新生入学体检、毕业生体检、在校学生因症就诊、密切接触者筛查确定诊断为活动性肺结核患者的资料进行统计分析，4种方式发现的活动性肺结核患者分别是39、31、49、2例，对其患病率和登记率进行卡方检验及线性趋势卡方检验，P〈O．05为差异有统计学意义。结果6年间新生及毕业生体检肺结核患病率分别平均为115．69／10万（39／33711）和101．81／10万（31／30450）、涂阳患者患病率分别为5．93／10万（2／3371I）和0（0／30450）；2008—2013年新生体检发现的活动性肺结核发病率分别为133．89／10万（7／5228）、135．99／10万（8／5883）、56．34／10万（3／5325）、73．27／10万（4／5459）、126．84／10万（8／6307）、163．37／10万（9／5509），卡方检验（X^2=3．985，P〉0．05）及线性趋势卡方检验（X^2趋势=0．134，P〉0．05），差异均无统计学意义；2008--2013年毕业生离校体检发现的活动性肺结核发病率分别为169．40／10万（9／5313）、120．92／10万（6／4962）、111．09／10万（6／5401）、79．78／10万（4／5014）、87．73／10万（5／5699）、24．62／10万（1／4061），对6年的活动性肺结核发病率进行卡方检验，差异无统计学意义（X^2=4．436，P〉0．05），但6年来活动性肺结核发病率的线性趋势卡方检验，差异有统计学意义（X^2趋势=4．744，P〈0．05），说明发病率呈下降趋势。在校学生因症就诊和密切接触者筛查肺结核患者登记率分别为41．15／10万（49／119069）和80．19／10万（2／2494），涂阳患者登记率为1．68／10万（2／119069）和0（0／2494），对两者发现的活动性肺结核患者登记率进行卡方检验（X^2=10．197，P〉0．05）及线性趋势卡方检验（X^2趋势=1．667，P〉0．05），差异均无统计学意义。结论多种肺结核患者发现方式相结合不仅在高校可行，而且是早期发现肺结核患者并防止结核病聚集性发病的有效措施。

Objective To analyze the effect of case-finding among students with tuberculosis （TB） in Xi＇An University of Finance and Economics from 2008 to 2013. Methods The TB patients were usually detected by the following four ways in the university： annual medical examinations for new students, annual medical examinations for graduates, seeking health care of students with symptoms and TB screening for close contacts of pulmonary TB patients. In six years （from 2008 to 2013）, the number of TB patients who were detected by those four ways were 39, 31, 49 and 2 respectively. The information of all detected TB patients were collected and analyzed. A Chi square test and linear trend Chi-square test were used to analyze TB prevalence and notification rate among students and the level of significance was set to P〈0. 05. Results In 6 years, the average prevalence of active TB among new students and graduates were 115.69/100 000 （39/33 711） and 101.81/100 000 （31/30 450） respectively; the average prevalence of smear-positive rib were 5. 93/100 000 and 0 （0/30 450） respectively. The TB prevalence of new students from 2008 to 2013 were 133.89/100 000 （7/5228）, 135.99/100 000 （8/5883）, 56.34/100 000 （3/5325）, 73.27/100 000 （4/5459）, 126.84/100 000 （8/6307） and 163.37/100 000 （9/5509） respectively, and the chi-square test and linear trend Chi-square test of had no statistically significant difference （X^2 = 3. 985, P〉0.05; X^2tmend=0. 134, P〉0.05）. The TB prevalence of graduates from 2008 to 2013 were 169.40/100 000 （9/5313）, 120. 92/100 000 （6/4962）, 111.09/100 000 （6/5401）, 79.78/100 000 （4/5014）, 87.73/100 000 （5/5699） and 24.62/100 000 （1/4061） respectively, and the Chi-square test had no statistically significant difference （X^2 =4. 436, P〉0.05） while the linear trend Chi-square test had which indicated a decreasing trend of TB prevalence. statistically significant difference （X^2rend = 4. 744, P〈 0. 05） The average notification rate of active TB among students by seeking health care and close contacts screening were 41.15/100 000 and 80.19/100 000 respectively and the notifi- cation rate of smear-positive rib were 1.68/100 000 （2/119 069） and 0 （0/2494）. The Chi-square test and linear trend chi-square test of the TB notification rate had no statistically significant difference （X^2 = 10. 197, P〉0.05; X^2tene = 1. 667, P〉0.05 ）. Conclusion A combination of various methods on TB case^finding is not only feasible in college, but also effective on early diagnosis of TB and prevention of spread of TB among students.