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    • 2019年广东省连江口镇≥5岁常住人口肺结核主动筛查策略实施效果分析

    余美玲,吴惠忠,周琳,温文沛,赖晓宇,陈亮,廖庆华,周芳静

    Chinese Journal of Antituberculosis（2021）

    Cited 1|Views24
    Abstract
    目的 评价不同主动筛查策略对肺结核患者的发现效果.方法 2019年12月,以居委会(村)为单位,采用整群随机抽样的方法从广东省清远市英德市连江口镇11个居委会(村)抽取2个单位作为研究现场,对研究现场≥5岁的2800名常住人口进行问卷调查,收集基本信息,并进行肺结核可疑症状筛查、结核感染筛查[γ-干扰素释放试验(IGRA)]和胸部数字影像(DR)摄片检查,对上述检查任一阳性者的痰液标本开展痰涂片、培养及分子生物学检查.以临床诊断为参照标准,通过敏感度、特异度和受试者工作特征曲线下面积(AUC)评价不同筛查策略的发现效果.结果 2800名研究对象中,有肺结核可疑症状者272例(9.71％),胸部DR异常者301例(10.75％),结核感染筛查阳性者617例(22.04％);其中,胸部DR异常者中疑似肺结核者67例(22.26％).共发现活动性肺结核患者8例,发现率为285.71/10万,除1例为已登记并接受治疗的患者外,其他7例均为≥15岁胸部DR异常的新发现患者.以临床诊断为参照标准,胸部DR摄片筛查的敏感度和特异度最优,分别为7/8和88.28％(2207/2500),AUC值最大(0.88).结论 不同的主动筛查策略中,胸部DR检查的诊断价值最高,可作为主动筛查策略的优先选择.
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