【摘要】 目的 获得乡村医生潜伏性结核感染(latent tuberculosis infection,LTBI)情况,比较γ干扰素释放试验中的QuantiFERON-TB Gold In-Tube(QFT-GIT)和结核菌素皮肤试验(tuberculin skin test,TST)(纯化蛋白衍生物,PPD)检测LTBI的一致性。方法 采用横断面研究,选择内蒙古自治区巴彦淖尔市临河区为研究现场,于2011年11月对临河区227名乡村医生进行问卷调查,同时采用QFT-GIT和TST两种检测方法检测乡村医生中的LTBI者。共发放227份问卷,收回有效问卷227份,回收率100.0%。采用构成比、率等统计指标描述乡村医生的基本信息和LTBI率,计算Kappa值评价QFT-GIT和TST结果的一致性。结果 227名乡村医生完成QFT-GIT检测,以QFT-GIT检测结果为依据(排除2名不确定结果),225名乡村医生LTBI率为44.0%(99/225)。226名乡村医生完成了TST检测,以TST检测结果为依据,乡村医生LTBI率分别为59.3%(134/226)(硬结平均直径≥5mm)、41.2%(93/226)(硬结平均直径≥10mm)、22.6%(51/226)(硬结平均直径≥15mm)。TST以硬结平均直径5mm为阳性临界值时,Kappa值为0.415;以10mm为阳性临界值时,Kappa值为0.444;以15mm为阳性临界值时,Kappa值为0.358。结论 临河区被调查的乡村医生LTBI率较高,本研究显示两种检测一致性一般,有必要开展农村结核感染控制工作,降低乡村医生的LTBI率。更多还原

【Abstract】 Objective To acquire the status of latent tuberculosis infection(LTBI)among village doctors and compare the concordance between QuantiFERON-TB Gold In-Tube(QFT-GIT)and tuberculin skin test(TST,using purified protein derivative of tuberculin,PPD). Methods A cross-sectional study was adopted in Linhe district of Bayan Nur City of Inner Mongolia in November,2011.The questionnaire was used to collect information.Both of QFT-GIT and TST were used to detect the LTBI among 227 village doctors.Two hundred and twenty-seven questionnaires were issued,and the overall response rate was 100.0%.Statistical indexes,such as proportion,rate were used to describe village doctors’ basic information and the rate of LTBI.The concordance of QFT-GIT and TST was evaluated with Kappavalue. Results 227 village doctors completed QFT-GIT and excluded 2 indeterminate results,99 of 225 village doctors’ QFT-GIT results were positive,the rate of LTBI was 44.0%(99/225).Two hundred and twenty-six village doctors completed TST,the rates of LTBI were 59.3%(134/226)with cutoff of 5 mm,41.2%(93/226)with cutoff of 10 mm and 22.6%(51/226)with cutoff of 15 mm respectively.The Kappavalues were 0.415 with cutoff of 5 mm,0.444 with cutoff of 10 mm and 0.358 with cutoff of 15 mm respectively.Conclusion The rate of LTBI among 227 village doctors in Linhe district was higher,the agreement of these two methods was general.We should conduct tuberculosis infection control measures at village clinic,so that reduce the LTBI of village doctors.更多还原