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국민학교 아동의 결핵진단에 있어서 투버큐린(PPD) 피내반응검사의 의의

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 (The) value of tuberculin test in diagnosis of tuberculosis in school children 
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[한글]결핵의 퇴치는 아직 국민보건면에서 가장 우선적으로 해결되어야 할 중요한 과제의 하나로 결핵관리사업의 기본과제는 치료보다는 예방에 있으며. 조기발견과 조기치료 역시 시급한 문제라고 생각된다. 투버큐린반응검사와 X-선검사는 가장 효과적인 결핵의 진단방법들로서, 저자는 국민하교 아동 1002명을 대상으로 투버큐린반응검사를 실시하였고, 양성반응자중 198명에게 흉부 X-선 간접촬영을 시행하여 다음과 같은 결과를 얻었기에 보고하는 바이다. 1) 양성반응자는 전체 아동의 33.5퍼센트이었으며, 대체로 학년이 높아짐에 따라 양성반응율이 증가하였다. 2) 여자(35.9 퍼센트)가 남자(31.5퍼센트)보다 양성율이 다소 높았다. 3) 양성반응자중 경결의 크기가 10내지 19mm에 속하는 아동(77.4 퍼센트)이 가장 많았으며, 30mm 이상되는 강반응은 학년이 높아짐에 따라 증가하는 경향을 나타내었다. 4) BCG 접종자중에서 자연감염에 의한 양전자로 생각되는 아동이 17.8퍼센트, BCG 에 의한 양전자로 사료되는 아동은 19.7퍼센트 이었는데, 자연감염에 의한 양전율은 학년이 높아짐에 따라 대체로 점차 증가하였다. 5) 흉부 X-선 촬영자 198명중 20명(10.1퍼센트)에서 결핵병소가 발견되었는데, 이는 전아동 575명의 3.5퍼센트에 해당하였으며, 이들중 활동성 결핵병소를 보인 아동은 12명(2.1퍼센트)이었다. 6) 흉부 X-선상 결핵유병율은 남녀의 비가 2.1:1로 남자에서 더 높았다. 7) 흉부 X-선상 결핵유병율은 경결의 크기가 클수록 증가하였다.
[영문]In our country, tuberculosis is still one of the most important subjects of public health which must be dealt with first. Essential to the eradication of tuberculosis is protection, and early diagnosis and treatment are critical. The tuberculin skin test and chest X-ray have been the most effective methods for the detection of tuberculosis. In present study, a total of 1002 school children were tested with tuberculin (PPD 10 TU and 1 TU) and 198 children of the positive reacting group were given 70 mm indirect chest X-ray. The Following results were obtained; 1) Positive reaction was found in 33.5% of all the tested children, and generally the rate of positive reaction was increased in the higher grades. 2) The positive reaction rate of females (35.9%) was higher than that of males (31.5%). 3) Among positive reactors, the sizes of induration mostly fell into the range of 10 to 19 mm in diameter (77.4%), and strong positive reactions of more than 30 mm in diameter were found in the higher grades more frequently. 4) Among BCG vaccinated children, the positive conversion rate of tuberculin test by natural infection was 17.8%, and the BCG induced conversion rate was 19.7%. Among higher grade students both conversion rates were higher than for first grade students. 5) After receiving chest X-ray, 20 of 198 children (10.1%) were found to have tuberculous lesion, and this was 3.5% of all 575 children. Among them, 12 children (2.1%) had active pulmonary tuberculosis on chest X-ray. 6) The positive rate on chest X-ray was higher in males than in females, the ratio being 1.9 to 1. 7) The positive rate on chest X-ray was increased parallel with the induration size of tuberculin test.
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