幼年时卡介苗接种史与成年后结核感染的关系研究

Relationship between BCG Vaccination History and Adult Tuberculosis

目的 了解幼年时卡介苗接种史与成年后结核感染的关系。方法 调查某部队院校一次结核疫情中391名患者和接触者的卡介苗接种情况,并对所有人进行结核菌素试验（PPD）,采用回顾性队列研究对结果进行分析。结果接种史调查发现,城市学员卡介苗接种率为82.32%,高于农村学员的56.99%,2组差异有统计学意义（χ^2=29.756,P〈0.01）。回顾性队列研究发现,有卡瘢组PPD阴性率为29.30%,低于无卡瘢组的44.92%,差异有统计学意义（χ^2=8.9230,P〈0.01）;有卡瘢组PPD阳性率为49.45%,高于无卡瘢组的38.14%,差异有统计学意义（χ^2=4.24,P〈0.05）;有卡瘢组和无卡瘢组PPD强阳性率为21.25%和16.95%,差异没有统计学意义;有卡瘢组和无卡瘢组结核患病率为11.36%和9.32%,差异没有统计学意义。结论 幼年时卡介苗接种史与成年后结核感染没有明显关联。

Objective To investigate the relationship between BCG vaccination history and adult tuberculosis infection. Methods BCG vaccination histories of 391 patients and contact persons in an outbreak of tuberculosis in a military school were investigated, and Purified Protein Derivative of Tuberculin （ PPD ） test was carried out in all subjects. A retrospective cohort study was conducted to analyze the results. Results The BCG vaccination rate of urban students was significantly higher than that of rural students （82.32% vs. 56.99% ） （χ^2= 29. 756, P 〈0.01 ）. The PPD negative rate in the BCG scar group was significantly lower than in the no - scar group （29.30% vs. 44.92% ） （χ^2= 8. 9230, P 〈 0.01 ）, and the PPD positive rate in the BCG scar group was significantly higher than in the no - scar group （49.45% vs. 38.14% ） （χ^2 =4.24, P 〈 0.05）. There was no significant difference in the PPD strong positive rate （21.25% vs. 16.95% ） or the TB preva- lence （11.36% vs. 9.32% ） between the two groups. Conclusion There is no significant relationship between BCG vaccination history and adult tuberculosis.