Al-Marri M R, Kirkpatrick M B
Pulmonary and Critical Care Medicine, Qatar Armed Forces Medical Unit and Hamad General Hospital, Doha.
Int J Tuberc Lung Dis. 2000 Mar;4(3):237-9.
To evaluate the utility of the erythrocyte sedimentation rate (ESR) in the diagnosis of childhood tuberculosis.
Data were collected retrospectively from the Qatar National Tuberculosis (TB) Registry for children (birth to 14 years of age) from 1983 to 1996. The diagnosis of active tuberculosis was based on positive sputum cultures (or histology) or an abnormal chest radiograph that responded to anti-tuberculosis chemotherapy.
Of 144 childhood TB patients, 68 (47%) had an ESR documented at the time of diagnosis. Twenty-two children (33%) had a normal ESR (<10 mm/hour) and 46 children (67%) had an elevated ESR (> or =10 mm/hour) at the time of diagnosis. Culture positive and symptomatic children had significantly higher ESR values than culture negative and asymptomatic children, respectively, at the time of diagnosis. There was no significant difference in ESR values for children with extrapulmonary versus pulmonary disease, and likewise no significant correlation between either age or size of tuberculin skin test reactivity and ESR values.
Although an elevated ESR may be expected in children with tuberculosis, this study found that one-third of children with TB had a normal ESR at the time of diagnosis, and consequently there would seem to be little value in using ESR as a diagnostic test for childhood tuberculosis.
评估红细胞沉降率（ESR）在儿童结核病诊断中的作用。
回顾性收集1983年至1996年卡塔尔国家儿童结核病登记处（出生至14岁）的数据。活动性结核病的诊断基于痰培养阳性（或组织学检查）或对抗结核化疗有反应的异常胸部X线片。
144例儿童结核病患者中，68例（47%）在诊断时有ESR记录。22例儿童（33%）诊断时ESR正常（<10毫米/小时），46例儿童（67%）诊断时ESR升高（≥10毫米/小时）。诊断时，培养阳性和有症状的儿童ESR值分别显著高于培养阴性和无症状的儿童。肺外疾病与肺部疾病儿童的ESR值无显著差异，结核菌素皮肤试验反应性的年龄或大小与ESR值之间同样无显著相关性。
虽然结核病儿童可能预期ESR升高，但本研究发现三分之一的结核病儿童诊断时ESR正常，因此，将ESR用作儿童结核病的诊断试验似乎价值不大。
