目的 分析不同人群结核菌素皮肤试验(TST)强阳性者异烟肼预防用药后随访5年的结核病发病情况.方法 按数字表法随机选取2003年1至12月三类不同人群共12 598人,其中高校学生8 896人,进城农民工2 496人,有活动性肺结核密切接触者1 206人.将TST强阳性且肺部无异常的人群按1∶1的比例分为异烟肼预防用药组(服用10个月)和对照组(不接受任何预防治疗),两组均密切跟踪随访5年,分别记录第2年、第3～5年各组的结核病发病情况.采用x2检验比较两组以及三类不同人群结核病发病率的差异.结果 12 598名不同人群中,TST强阳性共897人(7.12％),其中大学生、农民工和密切接触者分别为316,388和193人,强阳性率分别为3.55％(316/8 896),15.54％ (388/2 496)和16.00％ (193/1 206),农民工和密切接触者的TST强阳性率明显高于大学生(x2=483.51和344.11,P＜0.01).TST强阳性人群中诊断为结核病37例.其中,大学生11例,结核病检出率为0.12％(11/8 896);农民工12例,结核病检出率为0.48％(12/2 496);密切接触者14例,结核病检出率为1.16％(14/1 206);农民工和密切接触者的结核病检出率明显高于大学生(x2=12.34和42.18,P＜0.01).随访2年,预防用药组429例中9例因药物不良反应停药,其余420例中9例发生结核病,发病率为2.14％(9/420);三类人群结核病的发病率分别为1.34％(2/149),1.60％ (3/188)和4.82％(4/83),三类人群比较差异无统计学意义(x2=2.92,P＞0.05).对照组31例发生结核病,发病率为7.23％(31/429),与异烟肼预防用药组比较差异有统计学意义(x2=12.69,P＜0.01).随访第3～5年,异烟肼预防用药组失访23例,其余388例中发生结核病8例,发病率为2.06％(8/388),三类人群结核病的发病率分别为1.41％ (2/142),2.35％(4/170)和2.63％(2/76),不同人群差异无统计学意义(x2 =3.11,P ＞0.05);对照组有17例发病,发病率为4.27％ (17/398),与异烟肼预防用药组比较差异无统计学意义(x2=2.47,P＞0.05).结论 进城农民工和活动性肺结核密切接触者是结核病高危人群,TST强阳性者异烟肼单药预防10个月,2年内预防效果明显.
目的 分析不同人群結覈菌素皮膚試驗(TST)彊暘性者異煙肼預防用藥後隨訪5年的結覈病髮病情況.方法 按數字錶法隨機選取2003年1至12月三類不同人群共12 598人,其中高校學生8 896人,進城農民工2 496人,有活動性肺結覈密切接觸者1 206人.將TST彊暘性且肺部無異常的人群按1∶1的比例分為異煙肼預防用藥組(服用10箇月)和對照組(不接受任何預防治療),兩組均密切跟蹤隨訪5年,分彆記錄第2年、第3～5年各組的結覈病髮病情況.採用x2檢驗比較兩組以及三類不同人群結覈病髮病率的差異.結果 12 598名不同人群中,TST彊暘性共897人(7.12％),其中大學生、農民工和密切接觸者分彆為316,388和193人,彊暘性率分彆為3.55％(316/8 896),15.54％ (388/2 496)和16.00％ (193/1 206),農民工和密切接觸者的TST彊暘性率明顯高于大學生(x2=483.51和344.11,P＜0.01).TST彊暘性人群中診斷為結覈病37例.其中,大學生11例,結覈病檢齣率為0.12％(11/8 896);農民工12例,結覈病檢齣率為0.48％(12/2 496);密切接觸者14例,結覈病檢齣率為1.16％(14/1 206);農民工和密切接觸者的結覈病檢齣率明顯高于大學生(x2=12.34和42.18,P＜0.01).隨訪2年,預防用藥組429例中9例因藥物不良反應停藥,其餘420例中9例髮生結覈病,髮病率為2.14％(9/420);三類人群結覈病的髮病率分彆為1.34％(2/149),1.60％ (3/188)和4.82％(4/83),三類人群比較差異無統計學意義(x2=2.92,P＞0.05).對照組31例髮生結覈病,髮病率為7.23％(31/429),與異煙肼預防用藥組比較差異有統計學意義(x2=12.69,P＜0.01).隨訪第3～5年,異煙肼預防用藥組失訪23例,其餘388例中髮生結覈病8例,髮病率為2.06％(8/388),三類人群結覈病的髮病率分彆為1.41％ (2/142),2.35％(4/170)和2.63％(2/76),不同人群差異無統計學意義(x2 =3.11,P ＞0.05);對照組有17例髮病,髮病率為4.27％ (17/398),與異煙肼預防用藥組比較差異無統計學意義(x2=2.47,P＞0.05).結論 進城農民工和活動性肺結覈密切接觸者是結覈病高危人群,TST彊暘性者異煙肼單藥預防10箇月,2年內預防效果明顯.
목적 분석불동인군결핵균소피부시험(TST)강양성자이연정예방용약후수방5년적결핵병발병정황.방법 안수자표법수궤선취2003년1지12월삼류불동인군공12 598인,기중고교학생8 896인,진성농민공2 496인,유활동성폐결핵밀절접촉자1 206인.장TST강양성차폐부무이상적인군안1∶1적비례분위이연정예방용약조(복용10개월)화대조조(불접수임하예방치료),량조균밀절근종수방5년,분별기록제2년、제3～5년각조적결핵병발병정황.채용x2검험비교량조이급삼류불동인군결핵병발병솔적차이.결과 12 598명불동인군중,TST강양성공897인(7.12％),기중대학생、농민공화밀절접촉자분별위316,388화193인,강양성솔분별위3.55％(316/8 896),15.54％ (388/2 496)화16.00％ (193/1 206),농민공화밀절접촉자적TST강양성솔명현고우대학생(x2=483.51화344.11,P＜0.01).TST강양성인군중진단위결핵병37례.기중,대학생11례,결핵병검출솔위0.12％(11/8 896);농민공12례,결핵병검출솔위0.48％(12/2 496);밀절접촉자14례,결핵병검출솔위1.16％(14/1 206);농민공화밀절접촉자적결핵병검출솔명현고우대학생(x2=12.34화42.18,P＜0.01).수방2년,예방용약조429례중9례인약물불량반응정약,기여420례중9례발생결핵병,발병솔위2.14％(9/420);삼류인군결핵병적발병솔분별위1.34％(2/149),1.60％ (3/188)화4.82％(4/83),삼류인군비교차이무통계학의의(x2=2.92,P＞0.05).대조조31례발생결핵병,발병솔위7.23％(31/429),여이연정예방용약조비교차이유통계학의의(x2=12.69,P＜0.01).수방제3～5년,이연정예방용약조실방23례,기여388례중발생결핵병8례,발병솔위2.06％(8/388),삼류인군결핵병적발병솔분별위1.41％ (2/142),2.35％(4/170)화2.63％(2/76),불동인군차이무통계학의의(x2 =3.11,P ＞0.05);대조조유17례발병,발병솔위4.27％ (17/398),여이연정예방용약조비교차이무통계학의의(x2=2.47,P＞0.05).결론 진성농민공화활동성폐결핵밀절접촉자시결핵병고위인군,TST강양성자이연정단약예방10개월,2년내예방효과명현.
Objective To examine the 5-year incidence of tuberculosis in different populations with strongly positive tuberculin skin test (TST) receiving preventive administration of isoniazide.Methods A total of 12 598 subjects including 8 896 college students,2 496 migrant workers and 1 206 close contacts with active pulmonary were selected from January to December 2003.Subjects with strongly positive TST but without abnormal lung findings were divided into isoniazide group (given isoniazide for 10 months) and control group (not given any drugs).The incidence of tuberculosis in year 2-5 were observed and compared usingx2 test.Results Among 12 598 subjects,897(7.12％) had strongly positive TST,including 316 college students,388 migrant workers and 193 close contacts,and the TST strongly positive rates were 3.55％ (316/8 896),15.54％ (388/2 496) and 16.00％ (193/1 206),respectively.Migrant workers and close contacts had higher TST positive rates than college students (x2 =483.51 and 344.11,P ＜ 0.01).Among 897 TST-positive individuals,37 were diagnosed as tuberculosis,including 11 college students,12 migrant workers and 14 close contacts,and the tuberculosis rates in three populations were 0.12％ (11/8 896),0.48％ (12/2 496) and 1.16％ (14/1 206),respectively.Migrant workers and close contacts also had higher tuberculosis rates than college students (x2 =12.34 and 42.18,P ＜0.01).In the second follow-up year,9 out of 429 subjects in isoniazide group quit the study due to adverse reactions,and in the rest 420 subjects,9 (2.14％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.34％ (2/149),1.60％ (3/188) and 4.82％ (4/83),and no significant difference was found (x2 =2.92,P ＞ 0.05).While in the control group,31 out of 429 (7.23％) individuals were diagnosed as tuberculosis,and the incidence was higher than that in isoniazide group (x2 =12.69,P ＜ 0.01).During the next three follow-up years,23 individuals in isoniazide group drop out of the study,and in the rest 388 subjects,8 (2.06％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.41％ (2/142),2.35％ (4/170) and 2.63％ (2/76),and no significant difference was found (x2 =3.11,P ＞ 0.05).While in the control group,17 out of 398 (4.27％) subjects were diagnosed as tuberculosis,and the incidence was not of significant difference compared with that in isoniazide group (x2 =2.47,P ＞ 0.05).Conclusion Migrant workers and close contacts are high risk populations of tuberculosis,and preventive administration of isoniazid for 10 months may reduce the incidence of tuberculosis in the following 2 years.
