CAJ | 학술논문

目的：研究新密地区6岁儿童对结核病的免疫应答和自然感染情况，以获得其在出生时的卡介苗接种率、卡痕率、结素强阳性率等指标，从而采取相应的补救和预防措施，以求降低结核病的发病率和遏制结核病。方法（1）市结防所监测6岁儿童结核病相关免疫力（观察卡痕，注射PPD，48～72h观察反应，并作好记录）；（2）无免疫力的儿童补种卡介苗；（3）PPD强阳性儿童（PPD直径≥15mm或有水泡者）到结防机构排查结核病，结核病患者纳入规划治疗，排除者预防服药（异烟肼+利福喷丁/每周用药2次，连服3～6个月），防止其以后发病（化学隔离）。结果（1）免疫应答率逐年增长，1996年是19.0%，2010年已达到56.7%；（2）卡痕率逐年增长，1996年31.3%逐步提高到2010年的92.7%；（3）接种卡介苗产生的阳性卡痕率逐年增长，1996年的42.8%逐步提高到2010年的98.2%；（4）PPD强阳性率逐年下降，1996年强阳性率3.0%，到2010年已是2.1%；（5）本组儿童结核病患病率由1996年的83/10万下降到2010年的零发病。结论控制结核病，从儿童抓起，这是我国结核病控制的一项基本政策。对学龄前儿童进行结核病监测，做到有病早治，无病早防，对降低结核病的发病有一定的促进作用。
목적：연구신밀지구6세인동대결핵병적면역응답화자연감염정황，이획득기재출생시적잡개묘접충솔、잡흔솔、결소강양성솔등지표，종이채취상응적보구화예방조시，이구강저결핵병적발병솔화알제결핵병。방법（1）시결방소감측6세인동결핵병상관면역력（관찰잡흔，주사PPD，48～72h관찰반응，병작호기록）；（2）무면역력적인동보충잡개묘；（3）PPD강양성인동（PPD직경≥15mm혹유수포자）도결방궤구배사결핵병，결핵병환자납입규화치료，배제자예방복약（이연정+리복분정/매주용약2차，련복3～6개월），방지기이후발병（화학격리）。결과（1）면역응답솔축년증장，1996년시19.0%，2010년이체도56.7%；（2）잡흔솔축년증장，1996년31.3%축보제고도2010년적92.7%；（3）접충잡개묘산생적양성잡흔솔축년증장，1996년적42.8%축보제고도2010년적98.2%；（4）PPD강양성솔축년하강，1996년강양성솔3.0%，도2010년이시2.1%；（5）본조인동결핵병환병솔유1996년적83/10만하강도2010년적령발병。결론공제결핵병，종인동조기，저시아국결핵병공제적일항기본정책。대학령전인동진행결핵병감측，주도유병조치，무병조방，대강저결핵병적발병유일정적촉진작용。
Objective To study the immune response to TB and TB natural infection of 6-year-old children in Xinmi region, in order to gain the indicators of BCG vaccination rate at birth, BCG scar rate and PPD strong-positive rate, thus take appropriate remedial and preventive measures to reduce the incidence of TB,control and eliminate TB. Methods (1) The TB associated immunity of all 6-year-old children were monitored in the antituberculosis institute of Xinmi(observing BCG scar for TB skin test and PPD response within 48-72h and making record). (2)The children who did not produce immune response were given BCG vaccination again. (3) The children with PPD strong-positive (the diameter of PPD was more than or equal to 15mm or there were the blisters in PPD reaction) were detected TB in the organization for TB. The children with TB were treated formally, and the children without TB were took disease-prevention medication (taking isoniazid and rifapentine twice a week for 3-6 months) in order to prevent its later onset(chemical isolation). Results (1)In 6-year-old children, the immune response rate of TB showed an increasing trend, that in 1996 was 19.0%, while that in 2010 was 56.7%;(2)The BCG scar rate showed an increasing trend, that in 1996 was 31.3%, while that in 2010 was 92.7%;(3)The positive BCG scar rate showed an increasing trend, that in 1996 was 42.8%, while that in 2010 was 98.2%; (4)The PPD strong-positive rate showed a declining trend, that in 1996 was 3.0%, while that in 2010 was 2.1%;(5)The incidence of TB was from 83/10 million in 1996 to zero in 2010 with a declining trend. Conclusion TB control from children is a basic policy for TB control in China. The TB monitor for the preschool children is necessary for preventing and treatmenting TB as early as possible, that plays a certain role in reducing the incidence of TB.