石家庄某高校学生结核病发病情况及随访观察

Follow-up study on the incidence of tuberculosis among students in a college of Shijiazhuang

目的了解大学生的结核病发病情况及相关因素,为制定学校结核病防控措施提供依据。方法选取河北经济管理学院2006级至2009级4届新生,按入学时的TB-PPD试验结果分为阴性组、一般阳性组和强阳性组,每届学生均观察3年,采用回顾性队列研究的方法对在校期间的结核病发病情况进行分析。结果 2006级至2009级共8 414人,有PPD结果 8 394人,阳性率、强阳性率分别为2006级39.0%,12.1%;2007级33.6%,7.6%;2008级46.4%,11.2%;2009级50.4%,13.0%,各年级之间差异均有统计学意义(P值均<0.05)。阳性率、强阳性率女生均高于男生,差异均有统计学意义(χ2值分别为6.003,39.938,P值均<0.05)。城市学生的阳性率(47.2%)高于农村学生(39.6%),强阳性率均为10.9%。累计观察25 242人年,共发现结核病人37例,年发病率为146.6/10万。PPD结果阴性组、一般阳性组、强阳性组的发病率差异有统计学意义(χ2=132.720,P<0.01),发病率与强阳性率呈正相关(r=1.00,P<0.01)。强阳性组中农村学生发病率高于城市(χ2=5.319,P=0.021)。结论青年学生是结核病的高危人群。应做为重点关注对象,给予适当的干预措施。

Objective The incidence of tuberculosis and related factors were studied to provide the guidelines for TB prevention and control in school. Methods 2005-2009 four-year freshman of Hebei Economy Management School were divided into negative group, positive group and strong positive group, according to the PPD test results. All the students were observed for 3 years, and the incidence of tuberculosis was analyzed during the period. Results There were a total of 8 414 students, the positive rate and strong positive rate were significant differences between 4 grades, as following： 2006 session 39.0%, 12.1%; 2007 session 33.5%, 7.5%; 2008 session 46.4%, 11.2%; 2009 session 50.4%, 13.0%. Positive rate and strong positive rate were different in different gender, and the positive rate of female was higher than that of male. The positive rate of urban origin students was 47.2% higher than that of rural, and the strong positive rate of them both were 10.9%. The accumulation of 25 242 person years was ob- served in this subject. A total of 37 TB patients were found, and the incidence rate was 146.5/105. The incidence of negative group, positive group and strong positive group were significantly different, and the incidence rate was positively correlated with the strong positive rate （r= 1, P〈0.01）. In addition, the study also found that the source of strong positive group in rural incidence rate was far higher than that in city （x^2= 5.319, P= 0.021）. Conclusion Young students with high risk of tuberculosis infection, especially students with strong positive PPD test, should be as the focus of concern, given appropriate interventions to reduce the inci- dence of tuberculosis.