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目的掌握衡水市6所高中、大中专院校的新生的肺结核发病情况,了解主要病因,提出科学的防治肺结核的策略和依据。方法对衡水市6所高中、大中专院校的29 828名新生进行结核菌素实验(PPD)监测,对PPD强阳性的学生进行X线拍片,对于确诊活动性肺结核要给予积极治疗,非活动性肺结核及PPD强阳性而胸片无异常要给予预防性治疗和追踪观察。结果 2011-2013年衡水市高中、大中专院校新生入学体检PPD强阳性率为12.3%,三年的PPD强阳性率分别为12.0%、12.1%、12.6%。新生活动性肺结核为107.3/10万,三年的活动性肺结核检出率分别为129.2/10万、116.2/10万、77.6/10万。3年间检出活动性肺结核患者33例,其中男性8例,女性25例,衡水学院检出患者所占构成比比较高(25/33),本地与异地生源发现活动性肺结核差异无统计学意义。结论这三年的活动性肺结核检出率是逐年降低的,但PPD阳性率是逐年增高的趋势,因此,结核病防控工作仍然不容小觑,要重视加强学生结核病防控工作的投入和管理,尤其是大学院校学生的结核病控制工作。
Objective To understand the incidence of tuberculosis in 6 new high schools and secondary and tertiary institutions in Hengshui City, to understand the main causes and to propose a scientific strategy and basis for preventing and treating tuberculosis. Methods A total of 29 828 freshmen from 6 high schools and technical secondary schools in Hengshui City were monitored for tuberculin test (PPD). X-ray films were taken from students with strong positive PPD, and positive treatment was given to confirmed active tuberculosis. Active pulmonary tuberculosis and PPD strong positive chest X-ray without exception should be given to preventative treatment and follow-up observation. Results From 2011 to 2013, the positive rate of PPD in freshmen in Hengshui city was 12.3%. The positive rates of PPD in three years were 12.0%, 12.1% and 12.6% respectively. The number of newly diagnosed active tuberculosis was 107.3 / 100000. The detection rates of active tuberculosis in three years were 129.2 / 100000, 116.2 / 100000 and 77.6 / 100000 respectively. 33 cases of active pulmonary tuberculosis were detected in 3 years, including 8 males and 25 females, with a relatively high proportion of patients (25/33) detected by Hengshui College. There was no significant difference in active tuberculosis between local and foreign students . Conclusion The detection rate of active tuberculosis in these three years is decreasing year by year, but the positive rate of PPD is increasing year by year. Therefore, prevention and control of tuberculosis should not be underestimated. Emphasis should be placed on strengthening the input and management of tuberculosis prevention and control. Especially for tuberculosis control among university students.