2015年重庆市沙坪坝区结核病防治重点人群胸部X线普查结果分析

Analysis of chest X-ray of susceptible population in Shapingba District in Chongqing in Year 2015

目的 准确获取重庆市沙坪坝区结核病防治重点人群结核病疫情,评价开展结核病防治重点人群进行胸部X线普查的实施效果.方法 收集2015年重庆市沙坪坝区5类（高二学生、高三学生、高校新生、社区管理老年人、食品及公共场所从业人员）结核病重点人群资料.上述重点人群均采用胸部X线（胸部透视或胸部摄片）进行普查,共检查164 970人,受检率为76.52％ （164 970/215 581）.患者资料来源于“结核病管理信息系统”,同时对患者检出及检出患者的临床症状、费用与产出等情况进行分析.结果 对5类重点人群活动性结核病检出率[高二学生,163.85/10万（13/7934）;高三学生,100.32/10万（10/9968）;高校新生,46.51/10万（21/45 147）;老年人群,22.05/10万（10/45 344）;从业人员,68.93/10万（39/56 577）]进行统计分析,差异有统计学意义（x2=31.53,P＜0.01）.新检出的93例活动性肺结核患者中,有79例无任何临床症状;5类人群结核病X线普查总投入经费为2 380 184元,每发现1例活动性结核病患者的经费投入为25 593元.结论 胸部X线普查对重点人群患者发现,特别是无症状患者的早期发现具有重要作用;不同类别重点人群的结核病检出率存在一定差异,应高度重视重点年级学生的结核病防控工作;需结合当地社会经济及卫生发展水平,选择合适的结核病筛查方式.

Objective This study aimed to detect tuberculosis （TB） prevalence of susceptible population in Shapingba District of Chongqing and the effect of chest X-ray in tuberculosis census.Methods Data of TB susceptible population （including the Grade Two and Grade Three students from Senior High Schools,freshmen from universities,and the aged in the community,workers from food industries and public places） from the tuberculosis information management system were collected.And 76.52% （164 970/215 581） of the population received chest X-ray （chest fluoroscopy or chest radiography）.Case detection rate,symptoms of identified cases and cost-effect were analyzed.Results Case detection rates were 163.85/105 （13/7934） in Grade Two students and 100.32/105 （10/9968） in Grade Three students of the Senior High Schools,46.51/105 （21/45 147） of the freshmen from universities,22.05/105 （10/45 344） of the aged people in the community,and 68.93/105 （39/56 577） of the workers from food industries and public places,the differences of the five groups were statistically significant （x2=31.53,P〈0.01）.Ninty-three cases were new active pulmonary TB,and among them,79 were with no clinical symptoms.A total of RMB 2 380 184 yuan was cost for the screening project and the cost of detection of per active TB case was RMB 25 593 yuan.Conclusion The chest X-ray screening plays an important role in the early TB detection in susceptible populations,especially in population with no clinical symptoms.TB detection rate are different in various susceptible population,and TB prevention for students should be emphasized.The local socio-economic development level should be taken in consider,and then select the appropriate TB screening methods.