切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (10) : 823 -825. doi: 10.3877/cma.j.issn.1674-0785.2020.10.014

所属专题: 文献

临床研究

活动性肺结核患者抗痨治疗前后PPD试验结果的分析
杨建功1, 王继成1,(), 黄兵1, 何永康1, 邵菊香1, 尹艳霞1   
  1. 1. 225400 江苏泰兴,泰兴市人民医院感染科
  • 收稿日期:2020-04-09 出版日期:2020-10-15
  • 通信作者: 王继成

Comparative analysis of PPD test results before and after antituberculosis treatment in patients with active tuberculosis

Jiangong Yang1, Jicheng Wang1,(), Bing Huang1, Yongkang He1, Juxiang Shao1, Yanxia. Yin1   

  1. 1. Department of Infectious Diseases, Taixing People's Hospital, Taixing 225400, China
  • Received:2020-04-09 Published:2020-10-15
  • Corresponding author: Jicheng Wang
引用本文:

杨建功, 王继成, 黄兵, 何永康, 邵菊香, 尹艳霞. 活动性肺结核患者抗痨治疗前后PPD试验结果的分析[J]. 中华临床医师杂志(电子版), 2020, 14(10): 823-825.

Jiangong Yang, Jicheng Wang, Bing Huang, Yongkang He, Juxiang Shao, Yanxia. Yin. Comparative analysis of PPD test results before and after antituberculosis treatment in patients with active tuberculosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(10): 823-825.

目的

研究PPD试验结果强阳性作为潜伏性结核诊断指标的可行性。

方法

选取2018年1月至8月在泰兴市人民医院住院,痰涂片抗酸杆菌(+)且PPD试验强阳性的继发性肺结核患者15例作为研究对象。抗痨治疗前行PPD试验检查,并记录其结果;抗痨满疗程,且临床判断肺结核治愈,在停药前再次行PPD试验,并记录结果,与抗痨前进行比较。

结果

15例痰涂片阳性,且PPD试验强阳性肺结核患者抗痨治疗前PPD平均直径为22.35 mm。抗痨治疗满疗程,且临床判断治愈,停药前PPD试验结果,15例均为强阳性,平均直径为25.46 mm。

结论

PPD试验强阳性通常见于活动性结核患者,本研究提示PPD试验强阳性也可发生于已治愈稳定的肺结核人群。故根据PPD试验强阳性诊断潜伏性结核感染推广预防性抗痨治疗需慎重。

Objective

To explore the feasibility of strongly positive reaction to the PPD test as a diagnostic index for latent tuberculosis.

Methods

Fifteen patients with secondary TB who were admitted to our hospital from January 2018 to August 2018, with sputum smears acid-fast bacilli (+) and strongly positive reaction to the PPD test were selected as study subjects. Before antituberculosis treatment, the PPD test was performed and the results were recorded. After the antituberculosis treatment course was completed and the pulmonary tuberculosis was clinically cured, the PPD test was performed again before the drug was discontinued. The results were compared between before and after antituberculosis treatment.

Results

The average diameter of PPD scleroma was 22.35 mm in these 15 patients before antituberculosis treatment. After the antituberculosis treatment course was completed and TB was clinically cured, the results of the PPD test were all strongly positive with an average diameter of 25.46 mm.

Conclusion

Although strongly positive reaction to the PPD test is usually seen in patients with active tuberculosis, it can also occur in tuberculosis populations with "cured and stable". Therefore, it should be cautions when administering prophylactic antituberculosis treatment for latent tuberculosis only based on strongly positive reaction to the PPD test.

表1 15例肺结核患者治疗前后PPD皮肤硬结大小情况
1
程馨禾, 边赛男, 张峣, 等. 潜伏性结核分枝杆菌感染的预防性治疗 [J/OL]. 中华实验和临床感染病杂志 (电子版), 2016, 10(2): 129-134.
2
中华人民共和国国家卫生和计划生育委员会. 中华人民共和国行业标准-结核病分类: WS 196-2017 [J]. 中国感染控制杂志, 2018, 17(4): 367-368.
3
鲁建民, 鲁滨, 刘晚霞. 某高校6534名新生结核菌素试验结果分析 [J]. 中国学校卫生, 2009, 30(3): 254-255.
4
李寒娟, 刘春梅, 许白桦, 等. 某高校2007--2010年学生结核菌感染与患病情况分析 [J].中国全科医师杂志, 2014, 13(10): 835-836.
5
王星, 刘全红, 李海, 等. 中学生PPD反应强度与结核发病及预防性治疗标准研究 [J].临床肺科杂志, 2012, 17(4): 665-667.
6
齐怡, 路华跃, 杨连菌, 等. 一起校园结核病爆发事件的回顾性分析 [J]. 结核病与肺部健康杂志, 2014, 3(3): 161-165.
7
何云军, 黄茂平, 曹乙, 等. 一起学校肺结核爆发性感染疫情分析及随访3年 [J]. 医学理论与实践, 2015, 28(13): 1810-1811.
8
Lee WS, Jang YS, Park CM, et al. The role of chest CT scanning in TB outbreak investigation [J]. Chest, 2010, 137(5): 1057-1064.
9
张云林, 白雪娟, 梁艳, 等. 驻京某部队新兵结核潜伏感染人群筛查新方法研究 [J]. 军事医学, 2017, 41(6): 462-465.
[1] 张丽帆, 杨峥蓉, 刘晓清. 程序性死亡受体1/程序性死亡配体在结核分枝杆菌感染免疫中的作用和宿主导向治疗前景[J]. 中华实验和临床感染病杂志(电子版), 2021, 15(03): 145-148.
[2] 程馨禾, 边赛男, 张峣, 刘晓清. 潜伏性结核分枝杆菌感染的预防性治疗[J]. 中华实验和临床感染病杂志(电子版), 2016, 10(02): 129-135.
阅读次数
全文


摘要