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Article(id=1325502045632995473, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025100, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736870400000, receivedDateStr=2025-01-15, revisedDate=1738944000000, revisedDateStr=2025-02-08, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953914316, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953914316, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953914316, creator=13701087609, updateTime=1793953914316, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=584, endPage=587, ext={EN=ArticleExt(id=1325502048619339922, articleId=1325502045632995473, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Latent infection and preventive treatment among students in 5 tuberculosis outbreaks in schools in Hunan Province, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic, so as to provide theoretical and technical support for tuberculosis prevention and control in schools.

Methods

Information on latent infection, preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023. Statistical analysis was conducted by using Chi-square test and Fisher's exact test.

Results

The prevalence of tuberculosis patients in close contacts (7.69%) and the latent infection rate of Mycobacterium tuberculosis (31.87%) were higher than those in non-close contacts (0.12%, 6.29%), and the differences were statistically significant (P < 0.01). The subsequent incidence of close contacts with latent infection was higher (8.62%) than that of non-close contacts (0), the rate of close contacts receiving prophylactic treatment (63.30%) was higher than that of non-close contacts (47.37%), and the proportion of close contacts receiving prophylactic treatment (68.12%) was higher than that of non-close contacts (45.56%), and the differences were statistically significant (P < 0.05). The latent infection rate of Mycobacterium tuberculosis in college students (13.58%) was higher than that in middle school students (7.08%) (χ2=37.77, P < 0.01). The proportion of college students receiving preventive treatment (100.00%) was higher than that of middle school students (40.34%), and the subsequent incidence of latent infection (6.67%) was higher than that of middle school students (0.54%); the rate of middle school students who should receive preventive treatment (70.41%) was higher than that of college students (30.77%), and the rate of middle school students who received preventive treatment (100.00%) was higher than that of college students (62.50%), and the differences were statistically significant (P < 0.01). Among the latent infected persons, 144 who completed preventive treatment did not get sick, and 10 of the 177 who did not complete preventive treatment got sick, with an incidence rate of 5.65%. The incidence rate of close contacts (19.23%) was higher than that of non-close contacts (0) (P < 0.01). There was no significant difference in the incidence of pulmonary tuberculosis between university (8.18%) and middle school (1.49%) among latent infected persons who did not complete preventive treatment (P=0.09).

Conclusion

Actively promoting preventive treatment for latent infections, especially among close contacts, and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.

, authors=Chuanfang ZHANG, Jun LIANG, Zuhui XU, Jiangjing FAN*, authorsList=Chuanfang ZHANG, Jun LIANG, Zuhui XU, Jiangjing FAN, authorCompany=null, correspAuthors=Jiangjing FAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325502051584712851, articleId=1325502045632995473, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=湖南省5起学校结核病疫情学生潜伏感染和预防性治疗情况, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析学校结核病聚集性疫情中潜伏感染和预防性治疗情况，为学校结核病防控工作提供理论和技术支持。

方法

选择2023年1—12月湖南省省级现场处置的5起学校结核病聚集性疫情，收集相关的潜伏感染、预防性治疗和结核病发病情况等资料。采用χ2检验和Fisher确切概率法进行统计分析。

结果

密切接触者肺结核罹患率(7.69%)、结核分枝杆菌潜伏感染率(31.87%)均高于非密切接触者(0.12%，6.29%)，差异均有统计学意义(P值均＜0.01)。潜伏感染的密切接触者后续发病率(8.62%)高于非密切接触者(0)，应预防性治疗的密切接触者接受预防性治疗率(63.30%)高于非密切接触者(47.37%)，接受预防性治疗的密切接触者接受化学预防性治疗方案比例(68.12%)高于非密切接触者(45.56%)，差异均有统计学意义(P值均＜0.05)。大学生结核分枝杆菌潜伏感染率(13.58%)高于中学生(7.08%)(χ2=37.77，P＜0.01)。接受预防性治疗的大学生接受化学预防性治疗方案比例(100.00%)高于中学生(40.34%)，潜伏感染的大学生后续发病率(6.67%)高于中学生(0.54%)；应预防性治疗的中学生接受预防性治疗率(70.41%)高于大学生(30.77%)，接受预防性治疗的中学生完成预防性治疗率(100.00%)高于大学生(62.50%)，差异均有统计学意义(P值均＜0.01)。潜伏感染者中144名完成预防性治疗者均未发病；177名未完成预防性治疗者有10例发病，发病率为5.65%，密切接触者发病率(19.23%)高于非密切接触者(0)(P＜0.01)。未完成预防性治疗的潜伏感染者后续肺结核发病率在大学(8.18%)和中学(1.49%)间差异无统计学意义(P=0.09)。

结论

对潜伏感染者尤其是密切接触者积极推广预防性治疗，尽可能做到应治尽治，可降低学校结核病发病率，有利于控制学校结核病疫情规模。

, authors=张传芳, 梁军, 徐祖辉, 范江静*, authorsList=张传芳, 梁军, 徐祖辉, 范江静, authorCompany=null, correspAuthors=范江静, authorNote=

张传芳(1983- )，女，湖南长沙人，硕士，主管医师，主要从事结核病防治工作。

, correspAuthorsNote=
范江静，E-mail：
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张传芳(1983- )，女，湖南长沙人，硕士，主管医师，主要从事结核病防治工作。

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(in Chinese), articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1325502053639921812, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502045632995473, xref=null, ext=[AuthorCompanyExt(id=1325502053669281941, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502045632995473, companyId=1325502053639921812, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=TB Control Department, Hunan Institute for Tuberculosis Control, Changsha (410013), Hunan Province, China), AuthorCompanyExt(id=1325502054009020566, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502045632995473, companyId=1325502053639921812, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=湖南省结核病防治所防治部，长沙 410013)])], figs=[ArticleFig(id=1325502065795014842, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502045632995473, language=EN, label=Tab.1, caption=

Comparison of treatment rate of latent infections in different groups

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项统计值应预防性治疗接受预防性治疗完成预防性治疗
人数治疗人数人数治疗人数人数治疗人数
接触情况密切接触者116109(93.97)10969(63.30)6964(92.75)
非密切接触者205190(92.68)19090(47.37)9080(88.89)
χ2值0.197.060.68
P值0.660.010.41
学校类型中学186169(90.86)169119(70.41)119119(100.00)
大学135130(96.30)13040(30.77)4025(62.50)
χ2值3.6246.38
P值0.06＜0.01＜0.01*
), ArticleFig(id=1325502065874706619, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502045632995473, language=CN, label=表1, caption=

不同组别的潜伏感染者预防性治疗率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项统计值应预防性治疗接受预防性治疗完成预防性治疗
人数治疗人数人数治疗人数人数治疗人数
接触情况密切接触者116109(93.97)10969(63.30)6964(92.75)
非密切接触者205190(92.68)19090(47.37)9080(88.89)
χ2值0.197.060.68
P值0.660.010.41
学校类型中学186169(90.86)169119(70.41)119119(100.00)
大学135130(96.30)13040(30.77)4025(62.50)
χ2值3.6246.38
P值0.06＜0.01＜0.01*
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湖南省5起学校结核病疫情学生潜伏感染和预防性治疗情况
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张传芳 , 梁军 , 徐祖辉 , 范江静 *
中国学校卫生 | 疾病控制 2025,46(4): 584-587
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中国学校卫生 |疾病控制 2025 , 46 (4) : 584 -587
湖南省5起学校结核病疫情学生潜伏感染和预防性治疗情况
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张传芳, 梁军, 徐祖辉, 范江静*
作者信息
  • 湖南省结核病防治所防治部，长沙 410013
通讯作者:
范江静，E-mail：
作者简介:

张传芳(1983- )，女，湖南长沙人，硕士，主管医师，主要从事结核病防治工作。

Latent infection and preventive treatment among students in 5 tuberculosis outbreaks in schools in Hunan Province
Chuanfang ZHANG, Jun LIANG, Zuhui XU, Jiangjing FAN*
Affiliations
  • TB Control Department, Hunan Institute for Tuberculosis Control, Changsha (410013), Hunan Province, China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025100
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摘要
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目的

分析学校结核病聚集性疫情中潜伏感染和预防性治疗情况，为学校结核病防控工作提供理论和技术支持。

方法

选择2023年1—12月湖南省省级现场处置的5起学校结核病聚集性疫情，收集相关的潜伏感染、预防性治疗和结核病发病情况等资料。采用χ2检验和Fisher确切概率法进行统计分析。

结果

密切接触者肺结核罹患率(7.69%)、结核分枝杆菌潜伏感染率(31.87%)均高于非密切接触者(0.12%，6.29%)，差异均有统计学意义(P值均＜0.01)。潜伏感染的密切接触者后续发病率(8.62%)高于非密切接触者(0)，应预防性治疗的密切接触者接受预防性治疗率(63.30%)高于非密切接触者(47.37%)，接受预防性治疗的密切接触者接受化学预防性治疗方案比例(68.12%)高于非密切接触者(45.56%)，差异均有统计学意义(P值均＜0.05)。大学生结核分枝杆菌潜伏感染率(13.58%)高于中学生(7.08%)(χ2=37.77，P＜0.01)。接受预防性治疗的大学生接受化学预防性治疗方案比例(100.00%)高于中学生(40.34%)，潜伏感染的大学生后续发病率(6.67%)高于中学生(0.54%)；应预防性治疗的中学生接受预防性治疗率(70.41%)高于大学生(30.77%)，接受预防性治疗的中学生完成预防性治疗率(100.00%)高于大学生(62.50%)，差异均有统计学意义(P值均＜0.01)。潜伏感染者中144名完成预防性治疗者均未发病；177名未完成预防性治疗者有10例发病，发病率为5.65%，密切接触者发病率(19.23%)高于非密切接触者(0)(P＜0.01)。未完成预防性治疗的潜伏感染者后续肺结核发病率在大学(8.18%)和中学(1.49%)间差异无统计学意义(P=0.09)。

结论

对潜伏感染者尤其是密切接触者积极推广预防性治疗，尽可能做到应治尽治，可降低学校结核病发病率，有利于控制学校结核病疫情规模。

结核  /  疾病暴发流行  /  病毒潜伏期  /  感染  /  预防和防护用药  /  学生
Objective

To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic, so as to provide theoretical and technical support for tuberculosis prevention and control in schools.

Methods

Information on latent infection, preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023. Statistical analysis was conducted by using Chi-square test and Fisher's exact test.

Results

The prevalence of tuberculosis patients in close contacts (7.69%) and the latent infection rate of Mycobacterium tuberculosis (31.87%) were higher than those in non-close contacts (0.12%, 6.29%), and the differences were statistically significant (P < 0.01). The subsequent incidence of close contacts with latent infection was higher (8.62%) than that of non-close contacts (0), the rate of close contacts receiving prophylactic treatment (63.30%) was higher than that of non-close contacts (47.37%), and the proportion of close contacts receiving prophylactic treatment (68.12%) was higher than that of non-close contacts (45.56%), and the differences were statistically significant (P < 0.05). The latent infection rate of Mycobacterium tuberculosis in college students (13.58%) was higher than that in middle school students (7.08%) (χ2=37.77, P < 0.01). The proportion of college students receiving preventive treatment (100.00%) was higher than that of middle school students (40.34%), and the subsequent incidence of latent infection (6.67%) was higher than that of middle school students (0.54%); the rate of middle school students who should receive preventive treatment (70.41%) was higher than that of college students (30.77%), and the rate of middle school students who received preventive treatment (100.00%) was higher than that of college students (62.50%), and the differences were statistically significant (P < 0.01). Among the latent infected persons, 144 who completed preventive treatment did not get sick, and 10 of the 177 who did not complete preventive treatment got sick, with an incidence rate of 5.65%. The incidence rate of close contacts (19.23%) was higher than that of non-close contacts (0) (P < 0.01). There was no significant difference in the incidence of pulmonary tuberculosis between university (8.18%) and middle school (1.49%) among latent infected persons who did not complete preventive treatment (P=0.09).

Conclusion

Actively promoting preventive treatment for latent infections, especially among close contacts, and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.

Tuberculosis  /  Disease outbreaks  /  Virus latency  /  Infection  /  Protective agents  /  Students
张传芳, 梁军, 徐祖辉, 范江静. 湖南省5起学校结核病疫情学生潜伏感染和预防性治疗情况. 中国学校卫生, 2025 , 46 (4) : 584 -587 . DOI: 10.16835/j.cnki.1000-9817.2025100
Chuanfang ZHANG, Jun LIANG, Zuhui XU, Jiangjing FAN. Latent infection and preventive treatment among students in 5 tuberculosis outbreaks in schools in Hunan Province[J]. Chinese Journal of School Health, 2025 , 46 (4) : 584 -587 . DOI: 10.16835/j.cnki.1000-9817.2025100
正文
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结核潜伏感染是指身体感染了结核分枝杆菌，但是处于未发病的一种状态；全球约有1/4的人已感染了结核分枝杆菌，这些潜伏感染者有5%~10%后续会发展为活动性肺结核患者[1-2]。学校结核病防控是我国结核病防治工作的重点，及时发现结核分枝杆菌潜伏感染者并给予预防性治疗，是做好校园结核病防控工作的重要措施之一。近年来，湖南省学生结核病疫情高于全国水平，学校聚集性疫情时有发生[3-5]。为此，本研究对2023年湖南省省级现场处置的学校结核病聚集性疫情中潜伏感染和预防性治疗情况进行分析, 从而为学校结核病防控工作提供理论和技术支持。
1　对象与方法
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1.1　对象
2023年1—12月，湖南有流行病学关联病例的学校结核病病例数超过4例的疫情有5起，其中中学3起，大学2起；共筛查3 622人，其中密切接触者筛查364人(10.05%)，包括中学生249人，大学生115人。湖南省结核病防治所均进行现场疫情处置，收集相关的结核分枝杆菌潜伏感染、预防性治疗和结核病发病等资料。本研究得到了湖南省结核病防治所伦理委员会的批准(批号：快LS2025011401)，每名筛查对象由父母/监护人或本人(≥18岁者)签署书面知情同意书。
1.2　调查方法
1.2.1　接触者筛查
按照《中国学校结核病防控指南(2020版)》[6]进行密切接触者和非密切接触者筛查。接触者筛查方案是对15岁以下的接触者同时进行肺结核可疑症状筛查和感染检测，包括结核菌素纯蛋白衍生物(parified protein derivative, PPD)、重组结核分枝杆菌融合蛋白(ESAT6-CFP10, EC)或γ-干扰素释放试验(interferon-gamma release assay, IGRA)；对15岁及以上的接触者，同时进行肺结核可疑症状筛查、感染检测和胸部X线片检查。密切接触者指与活动性肺结核患者在同一个教室学习的师生，在同一个宿舍居住的同学，或与病原学阳性/重症病原学阴性/症状明显的病原学阴性患者在诊断前3个月至开始治疗后14 d内直接接触8 h及以上或累计40 h者，或与其他病原学阴性患者在诊断前1个月内累计接触达40 h者[6-7]。
1.2.2　预防性治疗方案
按照《中国结核病预防性治疗指南》[8]，采用的预防性治疗方案包括化学预防性治疗方案(本研究均为异烟肼、利福平联合方案)和免疫预防性治疗方案(注射用母牛分枝杆菌)。
1.2.3　应预防性治疗对象
符合预防性治疗条件(即排除活动性结核病患者和预防性治疗禁忌症)的结核分枝杆菌潜伏感染者[8]；PPD中度及以上阳性、EC阳性或IGRA阳性判定为潜伏感染者[9]。
1.3　统计学分析
使用Excel 2016软件进行数据整理，应用SPSS 27软件对资料进行统计分析。计数资料以百分率或频数表示，组间比较采用χ2检验或Fisher确切概率检验。以P＜0.05为差异有统计学意义。
2　结果
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2.1　学校肺结核患者和潜伏感染情况
2023年5所学校中，筛查共发现肺结核患者32人(含潜伏感染者后续发病的患者)，罹患率为0.88%(32/3 622)；Fisher确切概率检验结果显示，密切接触者罹患率(7.69%，28/364)高于非密切接触者(0.12%，4/3 258)(P＜0.01)。中学和大学之间肺结核患者罹患率(0.72%，19/2 628；1.31%，13/994)差异无统计学意义(χ2=2.82，P=0.09)。
结核分枝杆菌潜伏感染率为8.86%(321/3 622)，其中密切接触者潜伏感染率(31.87%，116/364)高于非密切接触者(6.29%，205/3 258)(χ2=265.16，P＜0.01)；大学结核分枝杆菌潜伏感染率(13.58%，135/994)高于中学(7.08%，186/2 628)(χ2=37.77，P＜0.01)。
2.2　学校结核分枝杆菌潜伏感染者预防性治疗情况
结核分枝杆菌潜伏感染者中应预防性治疗对象占比93.15%(299/321)，应预防性治疗对象占比在不同接触情况和学校类型间差异均无统计学意义(P值均>0.05)。应预防性治疗对象中有159人接受预防性治疗，治疗率为53.18%(159/299)，其中密切接触者中接受预防性治疗率高于非密切接触者；中学的应预防性治疗对象中接受预防性治疗率高于大学(P值均＜0.05)。接受预防性治疗者中完成预防性治疗率为90.57%(144/159)，其中密切接触者和非密切接触者间差异无统计学意义(P=0.41)；而中学生完成预防性治疗率高于大学生(P＜0.01)。见表1。
2.3　结核分枝杆菌潜伏感染者发病情况
发现的32例肺结核患者中有10例为结核分枝杆菌潜伏感染者，首次筛查后3个月左右发现为肺结核患者。密切接触者的潜伏感染者后续发病率(8.62%，10/116)高于非密切接触者(0，0/205)，大学生潜伏感染者后续发病率(6.67%，9/135)高于中学生(0.54%，1/186)，Fisher确切概率检验结果显示，差异均有统计学意义(P值均＜0.01)。潜伏感染者中144名完成预防性治疗者均未发病；177名未完成预防性治疗者有10例发病，发病率为5.65%，密切接触者发病率(19.23%，10/52)高于非密切接触者(0，0/125)，Fisher确切概率检验结果显示差异有统计学意义(P＜0.01)；而未完成预防性治疗的潜伏感染者后续肺结核发病率在大学和中学生间(8.18%，9/110；1.49%，1/67)差异无统计学意义(P=0.09)。
2.4　预防性治疗方案比较
接受预防性治疗者中化学药物预防性治疗方案占比为55.35%(88/159)，免疫预防性治疗占比为44.65%(71/159)。接受预防性治疗的密切接触者中，接受化学预防性治疗方案比例为68.12%(47/69)，接受免疫预防性治疗的比例为31.88%(22/69)；接受预防性治疗的非密切接触者中，接受化学预防性治疗方案比例为45.56%(41/90)，接受免疫预防性治疗的比例为54.44%(49/90)，差异有统计学意义(χ2=8.04，P=0.01)。接受预防性治疗的中学生中，接受化学预防性治疗方案比例为40.34%(48/119)，接受免疫预防性治疗的比例为59.66%(71/119)；接受预防性治疗的大学生中，接受化学预防性治疗方案比例为100.00%(40/40)，接受免疫预防性治疗的比例为0，差异有统计学意义(χ2=43.12，P＜0.01)。
3　讨论
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有研究显示，结核分枝杆菌潜伏感染率与结核病发病率呈正相关[10]，对学校结核分枝杆菌潜伏感染者进行预防性治疗以降低潜伏感染率，可以降低学校结核病发病率，尤其是降低学校结核病聚集性疫情的发生。
本研究对2023年省级参与处置的湖南省5起学校结核病聚集性疫情进行分析，发现结核分枝杆菌潜伏感染率为8.86%，其中密切接触者潜伏感染率达到31.87%，高于非密切接触者，与其他研究结果相似[11]。因此，密切接触者是结核病防控重点需要关注的对象。
密切接触者中肺结核患者的检出率为7.69%，高于非密切接触者，与廖龙等[7, 12]研究结果相似，密切接触者接受预防性治疗比例高于非密切接触者。可能是因为发现聚集性疫情后，密切接触的潜伏感染者后续更易患结核，教育和卫生部门担心学校结核病疫情加重及舆情的出现，更重视针对密切接触者的宣传，积极采取措施要求进行预防性治疗。在本研究中，化学预防性治疗比例高于免疫预防性治疗比例。有研究发现，化学预防性治疗保护效果为60%~90%[13-14]，免疫预防性治疗保护效果仅为54.7%[13]，因此在密切接触者中更推荐化学预防性治疗方案。
有研究显示，大学新生的结核分枝杆菌潜伏感染率高于中学生[15]，与本研究结果一致。可能是随着年龄增长，结核分枝杆菌潜伏感染率存在不断升高的趋势[16-17]，而且大学生活动范围更广、社交圈子也更为复杂，使得结核分枝杆菌潜伏感染率更高。
符合预防性治疗的潜伏感染者中中学生肺结核接触者接受和完成预防性治疗比例均高于大学生。可能是中学生处于相对更为封闭和管理的学校环境中，受家长和老师的约束较多，对于学校组织的预防性治疗措施有较高的依从性。大学生因为自主性增强，受家庭教育的影响相对减弱，受学校约束也相应降低；并且与中学相比，大学对学校结核病防控工作重视度存在不足[18]。因此，大学生接受和完成预防性治疗比例比中学生低，导致本研究中大学潜伏感染者后续肺结核发病率高于中学。
潜伏感染者中，完成预防性治疗者均未发病，未完成预防性治疗者有10例发病，且均为密切接触者。因此，应高度重视结核病预防性治疗，减少后续病例数量，尤其是在发生聚集性疫情时。因为被感染的密切接触者往往都是新近感染者，近期发生活动性肺结核的风险高，因此，对于学校结核病疫情处置中发现的符合预防性治疗标准的感染者均应动员其进行预防性治疗，尽可能做到应治尽治[19]。

文献
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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025100
  • 接收时间：2025-01-15
  • 首发时间：2026-11-06
  • 出版时间：2025-04-25
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  • 收稿日期：2025-01-15
  • 修回日期：2025-02-08
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    湖南省结核病防治所防治部，长沙 410013

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范江静，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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