Khosroshahi H T, Shoja E A, Beiglu L G, Hassan A P
Kidney Transplant Center, Imam Hospital, Tabriz, Iran.
Transplant Proc. 2006 Sep;38(7):1982-4. doi: 10.1016/j.transproceed.2006.06.016.
Immunocompromised patients such as those with chronic renal failure requiring hemodialysis (HD) are at increased risk of developing tuberculosis (TB). The gold standard screening tool used to detect tuberculosis is the tuberculin test, which owes its popularity to its ease of administration and high sensitivity. This study was done to identify the incidence of tuberculin test positivity among dialysis patients before transplantation and also in volunteer living kidney donors.
This cross-sectional, comparative study was done on 308 kidney allograft recipient candidates, 80 potential living unrelated and related donors within a few months before transplantation, and 855 control cases before employment. Patients were tuberculin-tested using the Mantoux technique. The PPD (purified protein derivative)-positive dialysis patients were compared with PPD-negative subjects, regarding age, gender, dialysis duration, cause of chronic renal failure, and nutritional state as well as PPD test results in potential donors. Patients were divided into <10 mm versus > or =10 mm induration. Statistical analysis was performed using SPSS 11.0.
The mean age of the donors was 26.6 +/- 4.6 years with a male:female ratio of 87.5%:12.5%. The tuberculin test was positive in 11.25% of cases, all of whom were males with with induration >10 mm. There was no significant difference regarding the PPD results and age. The mean age of recipients was 40.1 +/- 14.7 years with a male/female ratio of 1.3:1. The tuberculin test was positive in 33.6% of recipient candidates. Mean duration on dialysis was 2.5 +/- 1.2 years. No significant correlation existed regarding the dialysis duration, cause of renal failure, c-reactive protein, erythrocyte sedimentation rate, and response to tuberculin test. There was a direct relationship between age and PPD test results (Pearson correlation +192).
Our results showed that more dialysis patients were PPD positive compared with donors.
免疫功能低下的患者，如那些需要血液透析（HD）的慢性肾衰竭患者，患结核病（TB）的风险增加。用于检测结核病的金标准筛查工具是结核菌素试验，它因易于实施和高敏感性而广受欢迎。本研究旨在确定移植前透析患者以及活体肾供者志愿者中结核菌素试验阳性的发生率。
这项横断面比较研究对308名肾移植受者候选人、移植前几个月内的80名潜在活体非亲属和亲属供者以及855名就业前对照病例进行。使用曼托试验对患者进行结核菌素检测。将PPD（纯化蛋白衍生物）阳性的透析患者与PPD阴性受试者在年龄、性别、透析时间、慢性肾衰竭病因、营养状况以及潜在供者的PPD检测结果方面进行比较。患者分为硬结<10mm和≥10mm两组。使用SPSS 11.0进行统计分析。
供者的平均年龄为26.6±4.6岁，男女比例为87.5%:12.5%。结核菌素试验11.25%的病例呈阳性，所有阳性者均为男性，硬结>10mm。PPD结果与年龄无显著差异。受者的平均年龄为40.1±14.7岁，男女比例为1.3:1。33.6%的受者候选人结核菌素试验呈阳性。平均透析时间为2.5±1.2年。透析时间、肾衰竭病因、C反应蛋白、红细胞沉降率与结核菌素试验反应之间无显著相关性。年龄与PPD检测结果之间存在直接关系（Pearson相关性+192）。
我们的结果表明，与供者相比，透析患者中PPD阳性者更多。
