BCG-PPD与TB-PPD在学生结核病筛查中的应用

Application of BCG-PPD and TB-PPD in student tuberculosis screening

目的了解卡介菌纯蛋白衍生物(BCG-PPD)和结核菌素纯蛋白衍生物(TB-PPD)在高中生及大学新生中结核病筛查效果,为今后做好学校结核病筛查工作提供科学依据。方法 2016年随机抽取一所高中和大学,对高一、高二2 884名学生和大学4 591名入学新生按班级随机使用5IU BCG-PPD和2IU TB-PPD进行皮肤试验,72 h查验结果,对BCG-PPD和TB-PPD阳性率和强阳性率分别进行统计分析。结果不同剂型PPD阳性率在高中组和大学新生组、同性别间的差异有统计学意义(P<0.01)。同种剂型PPD阳性率高中组与大学新生组、同性间的差异有统计学意义(P<0.01)。不同剂型、同性间PPD强阳性率在高中组差异无统计学意义(P>0.05);在大学新生组间差异有统计学意义(P<0.05)。同剂型、同性间,BCG-PPD强阳性率差异有统计学意义(P<0.05);TB-PPD强阳性率差异无统计学意义(P>0.05)。结论 2IU TB-PPD的阳性率和强阳性率均低于5IU BCG-PPD,2IU TB-PPD更适用于大规模学校结核病的初筛。

Objective To evaluate the effectiveness of purified protein derivative of BCG（BCG-PPD）and purified protein derivative of tuberculin（TB-PPD）in screening tuberculosis among senior high school students and freshmen,so as to provide an evidence for improving tuberculosis screening in schools.Methods In 2016,a senior high school and a college were randomly selected and 2 884 senior high school students and 4 591 university freshmen were randomly used 5IU BCG-PPD and 2IU TB-PPD respectively for skin tests according to the class.The results were checked 72 hours later,and the positive rates and strong positive rates of BCG-PPD and TB-PPD were investigated and the results were analyzed and compared.Results In the positive rate of PPD in the different dosage forms and the same sex,there was a significant difference between the senior high school group and college freshman group（P〈0.01）.With respect to the same dosage form of PPD and the same sex,there was a significant difference between the senior high school group and college freshman group（P〈0.01）.In the strong positive rate of PPD in the different dosage forms and the same sex,there was no statistically significant difference among the classes of the senior high school group（P〈0.05）,but there was a statistically significant difference among the classes of the college freshman group;in the strong positive rate of BCG-PPD in the same dosage form and same sex,there was a significant difference（P〈0.05）,but in the strong positive rate of TB-PPD,there was no significant difference（P〉0.05）.Conclusion The positive rate and strong positive rate of 2IU TB-PPD are lower than those of 5IU BCG-PPD,and therefore,2IU TB-PPD is more suitable for school tuberculosis screening on a large scale.