涂阳肺结核患者密切接触者结核感染及危险因素分析

Latent tuberculosis screening on close contact with patients with smear positive pulmonary tuberculosis

目的了解涂阳肺结核患者密切接触者结核感染情况及影响因素。方法采用T-SPOT.TB试剂盒检测与76例涂阳肺结核患者的243例密切接触者结核潜伏感染(LTBI)情况,采用Pearsonχ2检验分析LTBI的影响因素。结果 248例密切接触者中活动性肺结核检出率为2.02%,在243例密切接触者(剔除5例活动性肺结核患者)中T-SPOT.TB的阳性率为46.9%,经单因素分析显示于涂阳肺结核患者确诊前2个月内接触者及夫妻关系的密切接触者,LTBI危险性高,且差异有统计学意——分别为(χ2=6.925,P=0.006)和(χ2=8.447,P=0.038)。结论与涂阳肺结核患者密切接触者较普通人群结核感染发生率高,且不同接触人群LTBI发生比率不同。

Objective To investigate the risk factors of latent tuberculosis infection（ LTBI） on close contact with smear positive pulmonary tuberculosis. Methods A total of 243 subjects having close contact with 76 newly diagnosed pulmonary TB cases were enrolled. LTBI was assessed by T-SPOT. TB,and pearson χ~2 was used to analyze the risk factors for LTBI. Results Among 248 individuals having close contact with smear positive pulmonary TB,the rate of active TB was 2. 02%（ 5 /248）. The T-SPOT. TB positive rate were 46. 9% in close contacts（ Excluded5 patients with active TB）. Through univariate analysis,the contact with smear positive pulmonary TB diagnosed 2months before and the relationship of couples with smear positive pulmonary TB increased significantly the likelihood of LTBI（ χ~2= 6. 925,P = 0. 006,χ~2= 8. 447,P = 0. 038）. Conclusion The close contact with smear positive pulmonary TB has higher incidence of TB infection than general population,and the different types of close contacts have various LTBI incidence.