2021年深圳市龙岗区学校结核病健康体检结果分析

Analysis of tuberculosis health examination results in schools in Longgang District,Shenzhen in 2021

目的分析深圳市龙岗区学校结核病健康体检结果,为学校结核病防控工作提供参考依据。方法2021年在深圳市龙岗区学校开展结核病健康体检,小学和非寄宿制初中新生先进行肺结核密切接触史和肺结核可疑症状调查,对有肺结核密切接触史者开展结核菌素皮肤试验(purified protein derivative,PPD)。高中和寄宿制初中新生先进行肺结核可疑症状筛查和PPD试验,对肺结核可疑症状者和PPD试验强阳性者进行胸部X光片(或DR)检查。高二学生进行胸部X光片检查。结果2021年深圳市龙岗区209所学校完成结核病健康体检工作。问卷调查107248人,肺结核密切接触史者5人,可疑症状率为5.51‰。PPD试验20153人,强阳性率为0.36%。按年龄分层,小学、初中、大学合并为一组,高中单为一组,两组的强阳性率分别为0.05%和0.39%,差异有统计学意义(χ^(2)=5.145,P=0.023);公办和民办学校的PPD试验强阳性率分别为0.38%和0.30%,差异无统计学意义(P>0.05);男生PPD试验强阳性率(0.54%)高于女生(0.16%),差异有统计学意义(χ^(2)=20.213,P<0.001)。IGRA检测44人,阳性率为13.64%。胸部DR检查25595人,异常率为2.03‰;小学、初中、高中、大学学生的肺部影像学异常率分别为0‰、8.62‰、0.39‰和4.48‰,差异有统计学意义(P<0.001);男生的肺部影像学异常检出率(2.84‰)高于女生(1.19‰),差异有统计学意义(P=0.004);公办学校学生的肺部影像学异常检出率高于民办学校学生,差异有统计学意义(P<0.001)。共检出6例学生肺结核,检出率为4.73/10万;不同年级的肺结核检出率差异有统计学意义(P=0.006)。结论结核病健康体检可及早发现结核病患者和潜伏感染者,实现关口前移,阻遏学校肺结核疫情播散。应重视并落实学生的结核病健康体检工作。

Objective To analyze the results of tuberculosis(TB)health examination in schools in Longgang District,Shenzhen,and to provide a reference for the prevention and control of TB in schools.Methods School tuberculosis health checkup was carried out in all schools in Longgang District,Shenzhen in 2021,among which primary and non-boarding junior high school freshmen were first investigated for their close contact history of tuberculosis and suspected symptoms of tuberculosis,and PPD test was carried out for those with a history of close contact with tuberculosis.Senior high school and boarding junior high school freshmen were screened for suspicious symptoms of tuberculosis and PPD test first.Chest X-ray(or DR)examination was carried out for those with suspected symptoms of tuberculosis and those with a strongly positive tuberculin skin test.High school sophomores undergo chest X-rays.Results In 2021,209 schools in Longgang District,Shenzhen completed the TB health examination.Questionnaire survey of 107248 people,5 patients with close contact with tuberculosis,the suspicious symptom rate was 5.51‰.The strong positive rate of the PPD test was 0.36%in 20153 people.According to age,primary school,junior high school,and university were combined into one group,and senior high school was a single group.The strong positive rate of the two groups were 0.05%and 0.39%,respectively,and the difference was statistically significant(χ^(2)=5.145,P=0.023).The strong positive rate of public schools and private schools were 0.38%and 0.30%,respectively,and the difference was not statistically significant(P>0.05).The strong positive rate of boys(0.54%)was higher than girls(0.16%),and the difference was statistically significant(χ^(2)=20.213,P<0.001).IGRAs detected 44 people,with a positive rate of 13.64%.There were 25595 chest DR examinations,and the abnormal rate was 2.03‰.Among them,the abnormal rates of imaging studies for primary school,junior high school,senior high school,and university students were 0‰,8.62‰,0.39‰,and 4.48‰,respectively,and the differences were statistically significant(P<0.001).The detection rate of abnormal lung imaging in boys(2.84‰)was higher than that in girls(1.19‰),and the difference was statistically significant(P=0.004).The detection rate of abnormal lung imaging in public school students was higher than that in private schools,the difference was statistically significant(P<0.001).A total of six cases of pulmonary tuberculosis were detected in students,with a detection rate of 4.73/100000.There was a statistically significant difference in the detection rate of pulmonary tuberculosis among different grades(P=0.006).Conclusion Tuberculosis health examination can detect tuberculosis patients and latent infection early,realize the advance of the gate,and prevent the spread of the tuberculosis epidemic in schools.Attention should be paid to and implementation of the TB health examination for students.