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[潜伏性结核感染治疗前CT筛查用于接触者中临床结核病的诊断]

[CT screening before treatment of latent tuberculous infection for the diagnosis of clinical TB among contacts].

作者信息

Yoshiyama Takashi, Ogata Hideo

机构信息

Fukujuji Hospital, JATA, 3-1-24, Matsuyama, Kiyose-shi, Tokyo 204-8522, Japan.

出版信息

Kekkaku. 2008 May;83(5):411-6.

Abstract

OBJECTIVE

To evaluate the value of CT scan for the detection of tuberculous diseases among persons who are suspected to be infected at the contact examination.

SETTINGS

Fukujuji Hospital, Japan.

METHOD

Retrospective review of the medical records of 22 persons who were normal with plain chest X-ray at an outbreak at a private school, with which total 46 TB cases and 93 infected persons were detected by either symptomatic visits or contact examinations done mainly at public health centers. Among the 44 persons who visited Fukujuji Hospital, 4 persons were symptomatic visits, 3 persons were detected as TB cases by the contact examination at public health centers and 3 persons visited Fukujuji Hospital for the purpose of contact examination before examinations at the public health centers. Eight of these 10 persons were with abnormal chest plain Xray findings and the remaining two persons were normal with plain chest X-ray findings (group A). Among the 34 persons who were referred to Fukujuji Hospital from public health centers as the infected person without diseases, one person showed abnormal chest plain X-ray and 33 persons showed normal chest plain X-ray (group B). Group A persons were examined in June and Group B persons were examined in

RESULT

The 2 persons in the group A were with abnormal CT findings. They were not diagnosed as TB by the CT findings but followed up after sputum examinations. Both of them were diagnosed as TB by the positive TB culture. Among the 33 persons in the group B, 20 persons were tested with CT scan at the examination done before starting treatment of latent tuberuclous infection and six of these 20 persons were with abnormal findings and were judged as TB diseases.

DISCUSSIONS

In the case of outbreak with many TB cases and infected persons, CT should be considered for the detection of TB cases among contacts.

摘要

目的

评估CT扫描在接触检查中对疑似感染结核病患者结核病检测的价值。

地点

日本福住寺医院。

方法

回顾性分析一所私立学校暴发疫情时22名胸部X线平片正常者的病历,通过主要在公共卫生中心进行的症状性就诊或接触检查共检测出46例结核病病例和93名感染者。在前往福住寺医院就诊的44人中,4人是症状性就诊,3人在公共卫生中心的接触检查中被检测为结核病病例,3人在公共卫生中心检查前为接触检查目的前往福住寺医院。这10人中8人胸部X线平片有异常表现,其余2人胸部X线平片正常(A组)。在作为未患病感染者从公共卫生中心转诊至福住寺医院的34人中,1人胸部X线平片异常,33人胸部X线平片正常(B组)。A组人员于6月接受检查,B组人员于……接受检查

结果

A组的2人CT表现异常。CT检查结果未诊断为结核病,但在痰检后进行随访。两人结核培养均为阳性,均被诊断为结核病。B组的33人中,20人在潜伏性结核感染治疗开始前的检查中进行了CT扫描,这20人中有6人表现异常,被判定为结核病。

讨论

在结核病病例和感染者众多的暴发情况下,应考虑使用CT对接触者中的结核病病例进行检测。

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