潜伏性结核分枝杆菌感染的预防性治疗

Treatment of latent Mycobacterium tuberculosis infection

潜伏性结核分枝杆菌感染（LTBI）是结核分枝杆菌（Mtb）在体内的稽留状态,其诊断依据为结核纯蛋白衍化物（PPD）皮肤试验或干扰素释放试验（IGRA）阳性,且无临床症状或影像学证据。预防潜伏性结核感染发展为活动性结核病对于控制结核病疫情至关重要,国际上的预防性治疗方案主要有6-9个月单药异烟肼（INH）、3-4个月单药利福平（RIF）、3-4个月异烟肼联合利福平或利福喷丁（RPT）治疗。我国潜伏性结核感染预防性治疗研究数据有限,因此,加强医务工作者对LTBI高危人群的了解,尤其是各种预防性治疗方案在不同高危人群中应用的认识,对医务工作者选择有效的预防性治疗方案有着积极意义。

Latent Mycobacterium tuberculosis infection is pragmatically defined as infection with M. tuberculosis, as evidenced by a positive tuberculin skin test reaction and（or） a positive interferon-γ release assay（IGRA） result without clinical manifestations of active tuberculosis. Preventive treatment for latent tuberculosis infection（LTBI） plays an important role in tuberculosis（TB） control in public and private health. Internationally, isoniazid therapy for 6-9 months, rifampicin monotherapy for 3-4 months and isoniazid plus rifampicin or rifapentine for 3-4 months have proved to be efficient. However, data about preventive treatment of LTBI in China is limited. It is of great importance for medical workers to cognize the advantages and drawbacks of different regimens in high-risk populations, and to choose efficient preventive therapy in clinical practice.