目的 了解广州市越秀区学校肺结核患者发现工作及存在的问题,以便探索学校早期发现传染源的措施,为制订学校肺结核防控策略提供依据.方法 收集2013年1月1日至2016年12月31日在广州市越秀区居住、工作或就读的312例在校师生肺结核患者痰涂片和发现方式方面的资料,对在校师生患者在发现方面的特点进行分析.相关资料应用Stata 11.0软件进行统计学处理,组间率或构成比的比较采用χ2检验,以P<0.05为差异有统计学意义.结果 (1)学生患者23.6%(65/276)是通过主动发现,76.4%(211/276)是通过被动发现;教师患者66.7%(24/36)是通过主动发现,33.3%(12/36)是通过被动发现;两者间比较差异有统计学意义(χ2=29.0,P<0.001);(2)涂阳患者中被动发现占83.9%(104/124),主动发现占16.1%(20/124);涂阴患者中被动发现占63.3%(119/188),主动发现占36.7%(69/188);涂阴、涂阳患者发现方式进行比较,差异有统计学意义(χ2=15.5,P<0.001);(3) 菌阳患者密切接触者筛查发现患者占0.27%(5/1855);发现PPD强阳性者占14.4%(253/1755),其中只有5.5%(14/253)接受预防性抗结核治疗.结论 在校学生肺结核患者主要通过被动方式发现,而教师肺结核患者主要通过主动方式发现.加强学校群体的年度健康体检和涂阳患者密切接触者筛查、主动发现患者,有利于早期发现和控制传染源,避免聚集性疫情发生.“,”Objective The aims of this study are to understand the current situation and existing problems of the TB case-finding at schools in Yuexiu District of Guangzhou, and to find out the measures for early detection of the patients with infectious TB, and also to provide scientific evidences for development of the TB control program in the school.Methods A total of 312 patients with pulmonary TB, who received treatment at the Out-patient Department of Guangzhou Chest Hospital and worked or studied in the schools in Yuexiu District of Guangzhou from January 1st, 2013 to December 31st, 2016, were consecutively enrolled in the study.The information and data related to the case detection of those patients, for example the sputum smear examination results, were collected.Stata 11.0 software was used for the statistical analysis of the data.Chi-square test was used to compare the rates or constituent ratios between different groups and P<0.05 was considered to be statistically significant.Results Among the students, 23.6% (65/276) of the TB patients were found by an active case-finding method while 76.4% (211/276) of the TB patients were found by a passive case-finding method;among the teachers, 66.7% (24/36) of the TB patients were notified by an active case-finding method while 33.3% (12/36) of the patients were found by a passive case-finding method.The difference of the TB case-finding patterns between the students and the teachers was statistically significant (χ2=29.0, P<0.001).In the smear-positive TB patients, the proportion of the patients who were detected by an active case-finding method and a passive case-finding method was 83.9% (104/124) and 16.1% (20/124) respectively;in the patients with smear-negative TB, the proportion of the patients who were detected by an active cases finding method and a passive case-finding method was 63.3% (119/188) and 36.7% (69/188) respectively.The TB case-finding method between the smear-positive and smear-negative TB patient groups was significantly different (χ2=15.5, P<0.001).During the screening to the close contacts of the bacteriologically positive TB patients, 0.27% (5/1855) of those close contacts were diagnosed to be active TB patients and 14.4% (253/1755) of them were found to be PDD strong positive.Among 253 TB close contacts with PDD strong positive, only 5.5% (14/253) of them received preventive anti-TB treatment.Conclusion The TB patients among the students were mainly found by a passive case-finding method while the TB patients among the teachers were mainly detected by an active case-finding method.The active case-finding methods (such as the annual health examinations and the screening of the close contacts of smear-positive patients) should be strengthened in the school populations, and it will contribute to the early detection of TB and the infectious source control, as well as the avoidance of the aggregated epidemic occurrence.