胸内结节病患者的结核菌素试验

The tuberculin test in intrathoracic sarcoidosis

目的为临床诊断胸内结节病减少误诊误治提供依据。方法收集１９９１年至１９９６年住院治疗的３５例胸内结节病病例，按我国规定的测试方法对所有病例进行了结核菌素试验测定，并严格按判断标准进行结果判定。同时与国内外已报道病例结核菌素试验结果进行比较。结果３５例胸内结节病，１７例结核菌素试验为阳性，４例强阳性，阳性及强阳性率为６０％，明显高于国内外已报道的结节病结核菌素试验阳性发生率。结论结果提示，胸内结节病患者结核菌素试验可呈现阳性乃至强阳性，阳性或强阳性发生率的高低与国家／地区及其结核病发病率、患者年龄和患者外周血Ｔ淋巴细胞（ＴＬＣ）γ／δ表型差异相关。将结核菌素试验阴性或弱阳性作为诊断结节病的重要参考指标应慎重，尽可能减少误诊误治。

Objective To highlight the diagnosis and treatment of intrathoracic sarcoidosis. Method The clinical and laboratory data of 35 cases of intrathoracic sarcoidosis in Tianjin thoracic hospital from 1991 to 1996 were reviewed. Tuberculin tests for 35 cases of sarcoidosis were carried out and the results were evalnated. Simultaneously, the results have been compared with that of literature published. Result Of 35 cases of intrathoracic sarcoidosis 17 cases were tuberculin positive, 4 were strongly positive positive tuberculin reactivity (60%) was significantly higher than that published. Conclusion The results showed a considerably higher tuberculin positive rate, which may be due to the difference of positive tuberculin reactivity in different country or regions, age of patients and expression of gamma delta T cell receptor. The authors sugested that “sarcoidosis should be diagnosed with negative tuberculis reastivity” has to be reconsidered.