【作者】 季可佳；

【导师】 金明华；

【作者基本信息】 吉林大学 ， 公共卫生， 2010， 硕士

【摘要】 结核病(Tuberculosis)是由结核杆菌引起的一种慢性和缓发的传染病,结核菌可能侵入人体全身各种器官,但主要侵犯肺脏,肺结核最为常见。主要经呼吸道传播,排菌者为其重要的传染源。结核病严重危害人类健康。我国已将结核病列为学校重点防治的常见病之一。近年来关于各类学校结核病流行的情况常有报道,因此,了解学生结核病免疫水平,保障学生的身体健康,积极、主动发现病人,从而采取相应的预防措施,进行积极的干预治疗,有效的防治结核病在校园内的传播,对于初中、小学预防控制结核病具有重要意义。为了解长春市朝阳区初中与小学入学新生结核菌素感染情况,本文对长春市朝阳区38所初中与小学,5902名入学新生开展结核菌素(purifiedprotein derivative,PPD)测试,采用国家统一试验标准判断并对结果进行分析,测试结果显示:一般阳性率27.25%;中度阳性率7.66%,强阳性率0.98%,对PPD试验中度阳性及强阳性学生,向家长发出复查通知书,复查率为58.04 %,但未查出患结核病的学生。男性强阳性率1.05%;女性强阳性率0.91%;不同性别结核菌素试验比较差异无统计学意义(p > 0.05);小学生强阳性率0.53%,初中学生强阳性率1.30%,差异有统计学意义(p < 0.01),市区新生PPD强阳性率0.80%,乡镇新生强阳性率1.75%,乡镇学生的中度及以上阳性率高于市区学生,差异有统计学意义(p < 0.01)。新生有无BCG疤痕与PPD试验结果比较差异有统计学意义(p < 0.01)。由本研究结果可得到如下初步结论:长春市朝阳区初中与小学入学新生中虽未发现有学生患有结核病但说明这部分学生仍有患病危险,有关部门应加强管理,控制病例的出现;乡镇学生的强阳性率高于城市学生提示乡镇学生的患病危险比城市学生的患病危险性要高。本文通过对长春市朝阳区初中与小学入学新生结核菌素感染情况的分析,了解长春市朝阳区2009年初中与小学入学新生结核菌素感染情况,为今后开展学校结核病的防控工作提供可靠的科学依据。更多还原

【Abstract】 Tuberculosis (TB) is a chronic and delayed infectious disease caused by the mycobacterium tuberculosis. TB may invade various organs of the human body, but it mainly affects the lungs. In the folklore, TB is also known as the phthisis with a saying that Nine out of ten phthisical patients are destined to death, and it really does serious harm to human health.According to WHO’s report in 2005, nearly 1/3 of the world’s population is infected by TB with an annual growth of 8 to 10 million people being newly infected. In 2008. there are about 20 million TB patients all over the world with the mortality rate reaching a historic peak. Every year, there are about 2 million people who died of TB, and 98% of them were from the developing countries; TB is no longer just a problem of single disease, but developed into a major matter of the public health which has become a social economic problem blocking up the social development.In recent years, there are some reports on the outbreaks of TB in various schools, and it is reported that students are becoming a population at high risk of TB. Students are one of the susceptible populations of TB. and they are a special group with dense population and close contact with each other. What’s more, the early symptoms of TB on students are not typical without any obvious physical signs, and there is even no subjective symptom, which makes it easily to be ignored. Therefore, in the event of some cases, it can easily result in an epidemic outbreak. The consequences will not only affect the physical and mental health of teachers and students, but also disrupt the normal teaching order at school, which will cause serious social impact. Therefore, to strengthen the management of junior high school and primary school students, and conduct an effective control on TB at school is of far reaching importance for the prevention and control on the spread of TB among junior high school students and primary school students.PPD is a test to check whether the body is immune to TB, a common reference to determine TB infection, and also an early auxiliary method to diagnose whether the body is infected by TB. The test is simple and quick, sensitive and accurate on the detection of new cases, the diagnosis of TB, forecasting the prevalence of TB, and also the monitoring on BCG vaccination, with an accurate reflection of the situation of BCG vaccination and the infection of TB. It is of particular significance for having TB infection and the situation of susceptible populations under control, and drawing up measures to the prevention and treatment of TB. Objective:This paper conducts an analysis on the infection of tuberculin among junior high school and primary school freshmen in Chaoyang District of Changchun, and gets an understanding of the situation of the freshmen of 2009, in order to draw up effective measures to prevent and control the outbreak of TB at school, and provide a scientific basis for the future prevention and control on TB at school. Methods:5,902 freshmen from 38 junior high schools and primary schools in Chaoyang District of Changchun accepted the tuberculin (PPD) test, with the diagnosis in adoption of the unified test standard set by the state, data input and preparation in the application of EXCEL software, data processing and analysis in the application of the statistical software SPSS 14.0, and x2 test for the comparison between the false negative rates and positive rates of each group in the PPD test. Results:1. The PPD test on the 5,902 freshmen of primary schools and junior high schools in Chaoyang District of Changchun shows that: the false negative rate is 64.11%, general positive rate 27.25%, moderate positive rate 7.66%, and strong positive rate 0.98%.2. Strong positive rate among male is 1.05%, and female 0.91%; and the difference is not statistically significant (P>0.05);3. Strong positive rate among primary school students is 0.53%, and junior high school students 1.30%, and the difference is statistically significant (PO.01);4. PPD strong positive rate among urban freshmen is 0.80%, and students from villages and towns 1.75%, and the difference is statistically significant (P<0.01).5. Strong positive rate among students without BCG scars is 1.91%, and students with BCG scars 0.82%, and the difference is statistically significant (P<0.01)Conclusions:1. The PPD test results on the 5,902 freshmen of junior high schools and primary schools in Chaoyang District of Changchun show that there are no student suffering from TB; but the strong positive rate is 0.98%, and those students are at a risk of being attacked by TB. The relevant departments should strengthen the management and control on the appearance of cases.2. The strong positive rate among junior high school students in the PPD test is higher than that among primary school students.3. The strong positive rate among students from villages and towns in PPD test is higher than that among urban students, which indicates that rural students are at a higher risk than urban students.4. The strong positive rate among students without BCG scars in PPD test,is significantly higher than that among students with BCG scars, which indicates that BCG vaccination is helpful to prevent the infection of mycobacterium tuberculosis更多还原