上海市某区菌阳肺结核患者密切接触者结核分枝杆菌潜伏感染及其相关因素

Latent tuberculosis infection and associated risk factors among the tuberculosis contacts in one of district in Shanghai

目的 了解上海市闵行区肺结核患者密切接触者MTB潜伏感染的情况,并分析影响潜伏感染的相关因素.方法 以2009—2010年闵行区户籍的痰培养阳性的肺结核患者及其密切接触者为研究对象,问卷调查收集研究对象的基本信息及与患者接触的相关信息,对密切接触者进行结核感染T细胞斑点试验（T-SPOT.TB）,通过Pearson卡方检验和logistic回归分析影响MTB潜伏感染的相关因素.本研究为横断面研究.结果 共纳入59例菌阳肺结核患者和137名密切接触者,其中密切接触者男性54名,女性83名;年龄平均42岁,60岁以上118名,60岁以下19名.密切接触者MTB潜伏感染率为20%（27/137）.Logistic回归分析发现,接触场所的通风情况越差,发生MTB潜伏感染的风险越大,60岁以上的密切接触者发生潜伏感染（42.1%）的风险是60岁以下（16.1%）的3.9倍.每周与菌阳肺结核患者接触40 h以上的人群发生MTB潜伏感染（25.8%）的风险是40 h以下人群（6.8%）的4.2倍.结论 肺结核患者密切接触者MTB的潜伏感染率为19.7%.对密切接触者进行MTB感染筛查并采取有效的干预措施具有重要意义.

Objective To investigate the prevalence of latent tuberculosis infection （ LTBI ） and associated risk factors among the tuberculosis （ TB） contacts in Minhang District of Shanghai .Methods A self-designed questionnaire was used to acquire socio-demographic information and to assess the degree of exposure to index cases.LTBI screening was performed by T-SPOT.TB assay.Pearson chi-square test and Logistic regression analyses were used to identify the risk factors associated with LTBI among the TB contacts.Results A total of 137 contacts from 59 mycobacterial （ culture ） positive pulmonary TB patients were enrolled in this study.In these contacts, there were 54 men and 83 women, with the average age of 42. LTBI was identified in 20%（27/137） of these contacts.Several risk factors were found by logistic analyses in this study.The worse the ventilation in the exposure location was , the more likely to develop LTBI. Contacts aged more than 60 （42.1%） were 3.9 times more likely to develop LTBI than those aged less than 60 （16.1%）.Individuals in contact with TB patients for more than 40 h/week（25.8%） had a 4.2 times risk of LTBI as compared to those for less than 40 h/week（6.8%）.Conclusion The prevalence of LTBI was 20%among the TB contacts in this study , highlighting the need of TB screening and intervention among TB contacts.