不同类型及剂量结核菌素试剂皮肤试验结果分析

Analysis on the results of tuberculin skin test using different types and doses of purified protein derivative of tuberculin

目的通过对不同类型及规格的结核菌素皮肤试验(tuberculin skin test,TST)试剂在出国健康人群中结核杆菌感染检测结果的对比分析,使大家进一步了解不同类型、规格的试剂在用途和选择上的差异。方法选取2012—2014年在北京国际旅行卫生保健中心进行出国体检的健康人群21 515人作为研究对象,根据使用的不同类型及规格的试剂,将其分为3组,A组7 446人,使用规格为50 IU/ml×1ml的BCG-PPD;B组6 609人,使用规格为20 IU/ml×1ml的TB-PPD;C组7 460人,使用规格为50 IU/ml×1ml的TB-PPD,并对其皮试结果进行对比分析。结果 A组阳性率为66.99%;B组阳性率为37.78%;C组阳性率为42.75%,3组阳性率差异有统计学意义(χ2=1410.01,P<0.01),其中A组阳性率明显高于B组(χ2=1 199.81,P<0.01)和C组(χ2=884.26,P<0.01),而C组阳性率明显高于B组(χ2=35.89,P<0.01),C组的阳性率与2000年全国结核病流行病学调查结果 (44.5%)最接近。结论在出国体检时宜选用50IU/ml的TB-PPD作为TST试剂,可提高准确性和检出率。

Objective To understand the differences of application and option of the tuberculin by analysis on the results of tuberculin skin test （TST） using different types and doses of purified protein derivative of tuberculin （PPD） in exit people. Methods The subjects were 21 515 persons who had physical examination in the Beijing International Heahhcare Center from 2012 to 2014. They were divided into 3 groups. Group A were 7 446, using BCG-PPD with specification （50 IU/ml×lml）, group B were 6 609 using TB-PPD with specification （20 IU/ml×lml）, group C were 7 460, using TB-PPD with specification （50 IU/ml×lml） . The skin test results were compared and analyzed. Results The positive rate was 66.99% in group A, 37.78% in group B and 42.75% in group C. The positive rates among 3 groups had significant difference （X2=1410.01, P〈0.01） . The rate of group A was higher than that of group B （X2=-1 199.81, P〈0.01） and group C （X2=884.26, P〈0.01） . The rate of group C was higher than that of group B （X2=35.89, P〈 0.01） and was very close to that of the national tuberculosis epidemiological survey in 2000 （44.5%） . Conclusion TB-PPD with specification （50IU/ml×lml） for TST should be a priority for a bet- ter accuracy and detection rate in the exit physical examination.