韓國人 肺結核 通院患者 家族의 感染 罹患 및 治療에 關한 臨床的 硏究 = Study on the Tuberculosis Infection Rates, Morbidity Rates and Therapeutic Results of Household Contacts in Korea

다국어 초록 (Multilingual Abstract)

There are approximately 700,000 patients with pulmonary tuberculosis in Korea but less than 4,000 sanatorium beds. Therefore, the majority of patients including those who are infectious remain at home.
It has been recognized that the tuberculosis infection rates and morbidity rates among household contacts were higher than those of the general population. It is also felt that one of the important factors in the treatment of pulmonary tuberculosis is to diagnose the disease at an early stage and to institute early treatment. The importance of contact examination was stressed by various authors.
The purpose of this study was to estimate the infection rates, morbidity rates and therapeutic results of tuberculosis contacts and to study the factors which contribute to them.
The 6,818 cases (or 87.3 per cent) of 7,812 household contacts of 1,559 known tuberculosis cases were examined at the Chest Clinic of Severance Hospital. Tuberculin test (5TU) was done on 3,111 household contacts of which ages were less than 14 years.
1. The tuberculin reactions were positive in 47.3 per cent of the household contacts at 0-4 years of age, in 72.1 per cent of cases at 5-9 years of age and in 74.1 per cent of cases at 10-14 years of age. These data showed that the risk of infection among the household contacts was remarkably higher than that of the general population.
2. There was no significant difference in the infection rates between males (63.7%) and females (64.7%).
3. The infection rates of contacts were closely related to the extent of disease and bacteriologic status of the index cases.
4. The 879 cases (or 12.9 per cent) of 6,818 household contacts were found to have active pulmonary tuberculosis. The morbidity rates in the contacts were also closely related to the extent of disease and the bacteriologic status of sputum in the index cases and whether they slept in the same or different rooms. The morbidity rate of household contacts was higher when the index cases were females (Female 14.0%: Male 12.3%) or their ages were over 50 years (over fifty 19.6%: under fifty 12.2%). And when the index cases were grandparents the contact cases showed the highest morbidity (18.5%) and which was higher than between spouses (13.8%).
5. The morbidity rate of male contacts (15.0%) was higher than that of females (11.1%) and also there were some age specific defferences; very high rates (14.7-16.9%) in the age group of up to 4 years old and groups of above 20 years old, higher (17.8-18.7%) in over 50 years while very low rate (7.0-8.6%) among 5 to 19 years age group.
6. Therapeutic results of 500 index cases and those of 302 contact cases were analized. In the majority of contact eases, the disease was found at an early stage and instituted treatment early. On the other hand, the majority of the index cases were diagnosed as moderately or far advanced or in a cavitary stage and had prolonged irregular chemotherapy previously.
7. Therapeutic results of the contact cases were far superior than those of the index cases. The rates achieving inactivity by chemotherapy for 12 months were 33.5 per cent in the contact cases while the index cases were only 12.4 per cent.

목차 (Table of Contents)

• Ⅰ. 緖論
• Ⅱ. 硏究對象 및 方法
• A. 接觸家族의 感染
• 對象
• 方法
• B. 接觸家族의 罹患
• 對象
• 方法
• C. 罹患家族의 治療
• 對象
• 方法
• Ⅲ. 硏究成績
• A. 接觸家族의 感染
• 1. 感染率
• 2. 年齡 및 性別
• 3. Tuberculin反應의 크기
• 4. 指針患者의 病狀別
• 5. 指針患者의 排菌狀態
• B. 接觸家族의 罹患
• 1. 罹患率
• 2. 年齡 및 性別
• 3. 指針患者와 接觸患者의 病狀比較
• 4. Tuberculin陽性兒의 罹患狀況
• 5. Tuberculin反應의 크기
• 6. 指針患者의 年齡 및 性別
• 7. 指針患者의 病狀別
• 8. 指針患者의 排菌狀態
• 9. 家族關係
• 10. 居室狀態
• 11. 接觸其間
• C. 罹患家族의 治療
• 1. 指針患者와 接觸患者의 X-線 所見의 變化 比較
• 2. 指針患者와 接觸患者의 喀痰內 結核菌 陰轉率의 比較
• 3. 空洞의 閉鎖
• 4. 非活動性 到達
• Ⅳ. 總括 및 考按
• Ⅴ. 結論