2021–2022年南宁市学校结核潜伏感染者预防性治疗效果分析

doi:10.19871/j.cnki.xfcrbzz.2025.02.004

摘要/Abstract

摘要： 目的对2021–2022年期间在南宁市第四人民医院结核门诊就诊的南宁市272例学校结核潜伏感染者随访观察2年,进一步了解预防性服药预防结核发病的作用,为学校结核潜伏感染者预防性治疗提供科学依据。方法将2021年1月至2022年1月在南宁市第四人民医院进行结核筛查后诊断为结核潜伏感染者的学生分为干预组（预防性服药组）和对照组（未预防性服药组）,干预组149例,对照组123例,年龄3~18岁,收集年龄、性别、是否寄宿、是否有肺结核密切接触史等一般特征,随访观察24个月,分析两组研究对象的发病情况,并进一步分析发展成活动性结核病的相关危险因素。结果随访24个月时,干预组149例结核潜伏感染者有2例进展成活动性结核病（其中1例在1年内发病）;对照组123例有10例进展成活动性结核病（其中8例在1年内发病）。在随访12个月时和随访24个月时时,对两组结核潜伏感染者结核病的发病率进行比较,差异具有统计学意义（均P<0.05）。对学校结核潜伏感染者发展成活动性结核病的相关因素进行Logistic回归分析,结果显示：预防性抗结核治疗是结核潜伏感染进展为活动性结核病的保护因素（OR=0.071,P<0.05）,有肺结核密切接触史是结核潜伏感染进展为活动性结核病的危险因素（OR=5.546,P< 0.05）。随访结果发现,未预防性服药的结核潜伏感染者易在1年内发病（P=0.019）。结论对学校结核主动筛查早期发现的结核潜伏感染者,应尽早进行预防性治疗,尤其是与活动性肺结核患者密切接触的学生等新近感染者,应在1年内进行预防性治疗,可以减少结核病的发病,有助于减少学校结核病的传播。

关键词: 学校, 结核潜伏感染, 预防性治疗, 影响因素

Abstract: Objective To evaluate the effectiveness of preventive medication in preventing the development of tuberculosis among school students with latent tuberculosis infection and to provide a scientific basis for the necessity of preventive treatment for these students by conducting a two-year follow-up study on 272 cases of latent tuberculosis infection identified at the tuberculosis clinic of Nanning Fourth People's Hospital from 2021 to 2022. Method Students diagnosed with latent tuberculosis infection following tuberculosis screening at Nanning Fourth People's Hospital from January 2021 to January 2022 were divided into an intervention group (preventive medication group) and a control group (non-preventive medication group). The intervention group consisted of 149 individuals, and the control group consisted of 123 individuals, aged 3 to 18 years. General characteristics such as age, gender, boarding status, and history of tuberculosis contact were collected, and the subjects were followed up for 24 months to analyze the incidence of tuberculosis in both groups and to further analyze the risk factors for developing active tuberculosis. Result During the 24 months follow-up, 2 cases out of 149 in the intervention group progressed to active tuberculosis (with 1 case occurring within 1 year), in the control group of 123, a total of 10 cases progressed to active tuberculosis (with 8 cases occurring within 1 year). A statistically significant difference in the incidence of tuberculosis was observed when comparing the two groups at 12 months and 24 months of follow-up (P<0.05). Logistic regression analysis of the factors associated with the development of active tuberculosis from school latent tuberculosis infectors showed that preventive anti-tuberculosis treatment was a protective factor against the progression of latent tuberculosis to active tuberculosis (OR=0.071, P<0.05), and having a history of pulmonary tuberculosis contact was a risk factor for the progression of latent tuberculosis to active tuberculosis (OR=5.546, P<0.05). Follow up results showed that latent tuberculosis patients who did not take preventive medication were more likely to develop symptoms within one year (P=0.019). Conclusion Proactive screening for tuberculosis in schools to identify latent tuberculosis infectors early, and initiating preventive treatment as soon as possible, especially for those with a history of close contact with pulmonary tuberculosis, and conducting preventive treatment within 1 year of confirming recent tuberculosis infection, can reduce the incidence of tuberculosis and help reduce the spread of tuberculosis in schools.

Key words: Schools, Latent tuberculosis infection, Preventive treatment, Influencing factors

中图分类号:

黄献珍, 谭洁, 黄爱春, 朱庆东, 韦柳迎, 谢周华. 2021–2022年南宁市学校结核潜伏感染者预防性治疗效果分析[J]. 新发传染病电子杂志, 2025, 10(2): 19-23.

Huang Xianzhen, Tan Jie, Huang Aichun, Zhu Qingdong, Wei Liuying, Xie Zhouhua. The analysis of the prophylactic treatment effects for latent tuberculosis infection in schools in Nanning from 2021 to 2022[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(2): 19-23.

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