对不同人群采用不同方法肺结核病人检出率的研究

目的 了解我国目前肺结核可疑症状者在全人口中的比例和不同人群不同方法肺结核病人检出率。方法 对无肺结核可疑症状者和有肺结核可疑症状者，分别采用胸透筛选、直接摄片、直接痰菌检查等不同方法对照研究。结果 有肺结核可疑症状者占全人口的1．27％；无症状者采用胸透筛选法检出活动性病人数、菌阳病人数和涂阳病人数分别仅占无症状者人数(受检人数)的0．13％、0．04％和0．03％，有症状者检出活动性病人数、菌阳病人数和涂阳病人数分别占有症状者人数(受检人数)的16．82％、7．98％和6．。76％。有肺结核可疑症状者采用：直接摄片的活动性肺结核病人、菌阳病人和涂阳病人检出率，分别为17．92％、8．37％和6．83％；直接痰培养的菌阳病人检出率为8．95％。直接痰涂片：2个痰标本与3个痰标本的涂阳病人检出率分别为6．17％和7．08％。结论 1．27％的全人口肺结核可疑症状者是评价可疑症状者就诊率的指标；对咳嗽、咳痰≥3周或有咯血的肺结核可疑症状者进行检查是最符合成本效益原则的结核病人发现方法。对有肺结核可疑症状者应当采用直接摄片法和3个痰标本进行病人发现；直接痰培养的菌阳病人检出率最高，有条件的单位可开展痰培养检查。

The Finding Rate of Pulmonary Tuberculosis in Different Population by Different Method

Objective To understand the proportion of pulmonary tuberculosis symptomatic suspects in population and finding rate of tuberculosis patients in different population (with or without pulmonary tuberculosis symptoms ) by different method ( fluoroscopy screen, direct X-ray film, direct sputum examination ). Methods 1.To survey pulmonary tuberculosis symptomatic suspects (cough for more than three weeks) in population; 2.The pulmonary tuberculosis symptomatic suspects (PTSS) and non-pulmonary tuberculosis symptomatic suspects (NPTSS) were examined by fluoroscopy screen, direct X-ray film, direct sputum smear and culture. Result 1.The proportion of PTSS in population is 1.27%. 2. The finding rate of active pulmonary tuberculosis patients, sputum bacteria positive patients and sputum smear positive patients was 0.13%, 0.04% and 0.03% respectively in NPTSS examined by fluoroscopy screen method. The finding rate was 16.82%, 7.98% and 6.76% respectively in PTSS. 3. Examination of pulmonary tuberculosis symptomatic suspects: 1) The finding rate of active pulmonary tuberculosis patients, sputum bacteria positive patients and sputum smear positive patients were 17.92%, 8.37% and 6.83% respectively by direct X-ray film method. 2) The finding rate of sputum bacteria positive patients was 8.95% by direct sputum culture. 3) The finding rate of sputum smear positive patients was 6.17% by direct sputum smear with 2 samples and 7.08% with 3 samples. Conclusion That the proportion of PTSS in population was 1.27% is a parameter for estimating rate of pulmonary tuberculosis symptomatic suspects consultation. It is a case-finding method mostly in conformity with the principle of cost-effectiveness. The pulmonary tuberculosis symptomatic suspects should be examined by direct X-ray film and sputum smear with 3 samples.