结核感染与结核菌素皮试结果的相关性研究

A Correlation Study between Tuberculosis Infection and Tuberculin Skin Test

目的:研究结核菌素(Purified Protein Derivation,PPD)皮试在诊断潜伏结核感染和结核病中的意义。方法:2008年1月~2009年12月怀疑结核感染的2714例小儿PPD皮试,结果登记并随访分析,PPD阳性率在不同年龄组间、不同性别、有无卡介苗接种的卡疤组间进行χ2检验。结果:28例皮试硬结反应出现在4~7d;潜伏结核的感染率为22.2%(603/2714),结核病为5.8%(158/2714),卡介苗病为0.3%(8/2714);PPD+^+++的阳性率在各年龄组间、有无卡疤组间比较差异有统计学意义,在性别间比较差异无统计学意义。结论:因PPD皮试安全且不良反应小推荐为常规的结核病筛查,结果观察时间建议为3~5d;皮试的颜色与肿胀边界在判断结核感染上更有意义。

Objective：To study the significance of tuberculin skin test（Purified Protein Derivation,PPD）in diagnosis of latent tuberculosis infection and tuberculosis.Methods：Two thousand seven hundred and fourteen children suspected for tuberculosis infection from January 2008 to December 2009 were selected to conduct PPD skin test on and be registered with follow-up analysis of their results.Chisquare test analysis was chosen for PPD ＋~＋＋＋ positive rate among different age groups,genders and with or without the BCG vaccination scar groups.Results：New cases that hadn＇t been reported in both Chinese and foreign literature were found.There were 28 cases with indurations during 4 to 7 days after the test.Latent tuberculosis infection rate was 22.2 %（603/2714）,tuberculosis rate was 5.8 %（158/2714）and BCG disease rate was 0.3%（8/2714）.The differences of PPD positive rate were statistically significant not only between different age groups（P〈0.05）but also between groups with or without BCG vaccination scar（P〈0.05）.But the gender difference was not statistically significant（P〉0.05）.Conclusions：PPD skin test should be recommended as routine tuberculosis screening for preschool children due to its safety and rare side effects.Furthermore,the time for reviewing result should be altered to 3 to 5 days after skin test.Moreover,it is more meaningful to observe the color and the border of the skin swelling than the diameter of the swelling in TB infection decision.