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目的了解上海口岸赴美移民活动性肺结核的流行情况,防止结核病通过口岸跨境传播。方法按照美国2009年《移民结核病筛查与治疗技术指南》要求,对2010年1月—2014年12月上海口岸赴美移民人群进行活动性肺结核筛查和治疗。结果 2010年1月—2014年12月上海口岸赴美移民17 869名,共检出活动性肺结核患者23例,总检出率为128.71/10万;男性检出率为147.33/10万;女性检出率为115.35/10万;男女性别比为1.28∶1。检出率随年龄的增长而上升,20~30岁年龄组有一个小高峰,为200.8/10万;>70岁年龄组达到最高峰,为297.62/10万,60~70岁年龄组与>70岁年龄组检出率相当,为291.97/10万。经细菌学检测,23例患者中,检出涂阳培阳3例、涂阴培阳15例、涂阳培阴3例和涂阴培阴2例;18例菌株均属结核分枝杆菌;药敏试验结果为敏感株14例,耐药株4例(1例为耐多药肺结核(MDR-TB)[1],2例为单耐异烟肼,1例为单耐链霉素)。结论应加强对口岸重点人群(20~30岁和>60岁)的结核病监测,将胸部X射线检查与痰结核杆菌检测结合起来,可提高活动性肺结核的检出率。
Objective To understand the prevalence of active pulmonary tuberculosis (MTP) in immigrants from Shanghai Port to the United States and to prevent the spread of TB through ports. Methods According to the requirements of the US Technical Guidelines for Screening and Treatment of Migrants Tuberculosis in 2009, active tuberculosis screening and treatment were conducted for the immigrants from the ports of entry to the United States from January 2010 to December 2014. Results From January 2010 to December 2014, 17 869 immigrants from the Shanghai Port to the United States of America were detected, of whom 23 cases were found active pulmonary tuberculosis with a total detection rate of 128.71 / 100 000; the detection rate was 147.33 / 100 000 for males The detection rate was 115.35 / 100000; the male-female ratio was 1.28:1. The detection rate increased with the increase of age, with a small peak of 200.8 / 100000 in the age group of 20-30 years; the highest peak in the group of> 70 years old was 297.62 / 100000, the age group of 60-70 years old and> The detection rate was similar in the 70-year-old group at 291.97 per 100 000. Bacteriological examination, 23 patients, smear positive Yang found in 3 cases, smear Yin and Yang in 15 cases, Tu Yang Peiyin in 3 cases and Yin Yin Pei Yin in 2 cases; 18 strains are Mycobacterium tuberculosis; Susceptibility test results for the sensitive strains in 14 cases, resistant strains in 4 cases (1 case of multi-drug resistant pulmonary tuberculosis (MDR-TB) [1], 2 cases of single isoniazid resistant, 1 case of single streptomycin) . Conclusions Tuberculosis surveillance should be strengthened in the key population (20-30 years old and> 60 years old) at the port. Combining the chest X-ray examination with the detection of sputum Mycobacterium tuberculosis can increase the detection rate of active tuberculosis.