传染性肺结核患者家庭密切接触者结核隐性感染影响因素及隐性感染者预防性服药效果分析

Risk Factors and Preventive Effect Analysis of Latent Infection of Tuberculosis in Close Family Contacts of Active Tuberculosis Patients

目的了解传染性肺结核患者家庭密切接触者结核隐形感染影响因素,为制定有效的预防对策提供依据。方法选取2017年陕西省结核病防治院就诊的传染性肺结核患者密切接触者作为研究对象进行问卷调查,将结核菌素(PPD)试验强阳性者且同意参与试验的研究对象随机分为预防用药组和未给予预防用药组,随访并比较两组活动性肺结核感染率、以及肺结核感染的影响因素。结果共722名密切接触者进行了PPD检测,其中112例(15.51%)检测结果为强阳性。其中108例PPD强阳性密切接触者被随机分为预防用药组和未给予预防用药组,每组各54人。随访2年活动性肺结核感染人数分别为3和11人,具有统计学差异(P<0.05)。多因素Logistic回归分析结果显示,年龄为5岁以下及60岁以上、男性、吸烟和既往具有肺结核病史是传染性肺结核患者家庭密切接触者PPD强阳性患者发生活动性肺结核的危险因素(P<0.05);同时高中及以上文化程度、人均居住面积每增加1 m^2、以及预防用药为传染性肺结核患者家庭密切接触者PPD强阳性患者发生活动性肺结核的保护因素(P<0.05)。结论传染性肺结核患者家庭密切接触者结核感染率较高,应采取预防性治疗措施,从而能够有效的降低结核发病率,控制其传染性。

Objective To investigate the risk factors of latent infection of tuberculosis(LITB)in close family contacts of active tuberculosis patients,in order to provide reference for the effective preventive measures.Methods People having family close contacts of active TB patients treated in Shaanxi Tuberculosis Control and Prevention Hospital in 2017 were included as the research objects and surveyed by questionnaire.Objects showing strongly positive result in purified protein derivative(PPD)test and consenting to participate in the trial were randomly divided into two groups as prophylactic drug group and no prophylactic drug group.This study followed up and compared the rates of active tuberculosis infection and the influencing factors of TB infection between the two groups.Results This study tested 722 cases with close family contacts for PPD,among them 112 cases(15.51%)showed strongly positive,of which,108 participants were randomly divided into two groups,one group was given prophylactic medication,and the other group was not given prophylactic medication,each with 54 cases.In the 2-year follow-up,the infection numbers of active tuberculosis were 3 and 11,respectively,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that people aged younger than 5 year-old and older than 60 year-old,male,smoking and previous history of TB were risk factors for active TB in PPD strongly positively patients with close family contacts of infectious TB patients(P<0.05).At the same time,people with senior high school or above,per capita living area increased by 1 m^2,and preventive drugs were protective factors for active TB in PPD strongly positive patients with close family contacts of infectious TB patients(P<0.05).Conclusion People with close family contacts of infective tuberculosis patient have high infection rate of TB.Given this,preventive treatment should be taken to effectively reduce TB incidence and control TB contagion.