长葛市肺结核病患者家属结核分枝杆菌潜伏感染状况调查

Investigation of latent mycobacterium tuberculosis infection in family members of pulmonary tuberculosis patients in Changge

目的分析长葛市肺结核病患者家属结核分枝杆菌潜伏感染情况。方法选取长葛市2016年3月至2018年9月期间在我院诊断及登记的肺结核病患者(n=82)及其家属(n=478),采用问卷调查收集所有研究对象的相关信息,采用结核感染T细胞斑点试验进行肺结核病识别,分析与患者不同关系的家属结核分枝杆菌潜伏感染情况及其危险因素。结果478例肺结核病患者家属有84例诊断为结核分枝杆菌潜伏感染,感染率为17.57%,其中,夫妻关系阳性率最高(28.13%),其次为祖孙关系(20.69%)。经Logistic多因素分析显示,患者诊断时间长、伴有临床症状、女性家属、家属无业/退休、家属未接种卡介苗、共同居住、确诊前2个月内接触及接触时间长均是造成肺结核病患者家属结核分枝杆菌潜伏感染的危险因素(P<0.05)。结论在规范治疗肺结核病患者尽可能缩短排菌时间的同时,应加强对肺结核病患者家属的健康教育,提升其自我保护意识,做好病患家属的肺结核筛查及预防,以降低肺结核病发生率。

Objective To analyze the latent Mycobacterium tuberculosis infection in family members of pulmonary tuberculosis patients in Changge. Methods Collected through questionairs, the pulmonary tuberculosis patients(n=82), diagnosed and registered in our hospital from March 2016 to September 2018 in Changge,and their family members(n =478) were investigated. The T cell spot tuberculosis test was performed to identify pulmonary tuberculosis. The latent mycobacterium tuberculosis infection status in family members of patients and the risk factors to the infection were analyzed. Results Among 478 family members of pulmonary tuberculosis patients, 84 cases were diagnosed as latent infection of mycobacterium tuberculosis, and the infection rate was 17.57 %. The family members,spouses of the patients, had the highest positive rate of infection(28.13 %), followed by the grandparents or grandchildren of the patients wtih the detection rate of a(20.69 %). Logistic multiple factor analysis showed that patients with long diagnosis time, accompanied by clinical symptoms, female family members, unemployed/retired family members, family members who were not vaccinated with BCG, cohabitation, contact within 2 months before diagnosis and long-term exposure were risk factors to latent mycobacterium tuberculosis infection in family members of pulmonary tuberculosis patients(P<0.05). Conclusion In order to reduce the incidence of tuberculosis infections, we should strengthen the health education of the family members of tuberculosis patients, enhance their self-protection awareness, and do a better job in screening and preventing the tuberculosis infections of the patients’ family members.