活动性肺结核患者抗痨治疗前后PPD试验结果的分析

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

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.