Toure N O, Dia Y, Diatta A, Ndiaye E H M, Thiam K, Niang A, Fall N, Kane M, Mbae F, Cisse A, Hane A A
Clinique de Pneumologie du CHN de Fann, Dakar, Senegal.
Dakar Med. 2006;51(3):141-4.
Many studies have underlined the theorical and practical role of Skin Tuberculin Test (STT) as an important tool for the diagnosis and for the screening of tuberculosis in the population.
This prospective study evaluated STT in 51 smear positive tuberculosis patients and 108 contacts tuberculosis patients apparently in a good health condition. Twenty seven patients have disappeared before the end of the study and 7 patients were excluded for non suitable results. So we analysed only 73 cases.
The mean age was 34 years, with extreme of 1 and 77 years. There were 33 male and 40 female patients for a sex-ratio of 0,8. BCG vaccination scar was found in 64% of patients. We calculated the Body-Mass-Index and we found a proteinocaloric malnutrition (BMI<18,5) in 30%. The mean diameter of STT induration was 12,3mm with extremes of 7 and 20mm. Considering a STT < 7 mm as negative, 4 patients (5%) had a negative STT and 69 (95%) a positive STT. 13 of these 69 patients had a STT > 15mm. The age group of the 10 to 50 years had more positive STT. Meanwhile, according to the sexe and to the nutritional status, there was no statistical difference. All patients with a negative STT received BCG vaccination after 2 months of follow-up. Those with STT>15mm were examinated and had a chest X-ray the day of their enrolment, at the second month and at the sixth month and we didn't find any evolutive tuberculosis.
According to these results, we can conclude that STT is not an important test for the screening of pulmonary tuberculosis in contact patients. Clinical examination, chest X-ray and sputum smear remain very important for the diagnosis. Despite these results, STT remain the only validated technic between the different tuberculin tests. Its interest was twofold: the research of an acquired immunity against tuberculosis after BCG immunisation and it is clinical test for the diagnosis of tuberculosis in children.
许多研究都强调了皮肤结核菌素试验（STT）作为人群中结核病诊断和筛查的重要工具的理论和实际作用。
这项前瞻性研究评估了51例涂片阳性结核病患者和108例表面健康状况良好的结核病接触者的STT。27例患者在研究结束前失访，7例患者因结果不合适被排除。因此，我们仅分析了73例病例。
平均年龄为34岁，年龄范围为1岁至77岁。有33例男性和40例女性患者，性别比为0.8。64%的患者有卡介苗接种疤痕。我们计算了体重指数，发现30%的患者存在蛋白质热量营养不良（BMI<18.5）。STT硬结的平均直径为12.3mm，范围为7mm至20mm。将STT<7mm视为阴性，4例患者（5%）STT为阴性，69例（95%）为阳性。这69例患者中有13例STT>15mm。10至50岁年龄组的STT阳性率更高。同时，根据性别和营养状况，无统计学差异。所有STT阴性的患者在随访2个月后接种了卡介苗。STT>15mm的患者在入组当天、第二个月和第六个月进行了检查并拍摄了胸部X光片，未发现任何进展性结核病。
根据这些结果，我们可以得出结论，STT并非接触患者肺结核筛查的重要检测方法。临床检查、胸部X光片和痰涂片对于诊断仍然非常重要。尽管有这些结果，STT仍然是不同结核菌素试验中唯一经过验证的技术。其意义有两方面：研究卡介苗免疫后获得的抗结核免疫力，以及作为儿童结核病诊断的临床检测方法。
