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[对不同年龄组接种和未接种卡介苗的结核菌素反应性的评估]

[Evaluation of tuberculin reactivity in different age groups with and without BCG vaccination].

作者信息

Yildirim Ciğdem, Küçük Ali Ihsan, Ongüt Gözde, Oğünç Dilara, Colak Dilek, Mutlu Gönül

机构信息

Akdeniz Universitesi Tip Fakültesi, Tibbi Mikrobiyoloji Anabilim Dali, Antalya.

出版信息

Mikrobiyol Bul. 2009 Jan;43(1):27-35.

Abstract

Tuberculin skin test (TST) which is used in the diagnosis of tuberculosis disease and evaluation of latent tuberculosis cases, is an easily applied, reproducible and low cost test. This study was carried out to determine the tuberculin reactivity in BCG vaccinated and unvaccinated population, to investigate the variables (BCG vaccination, the number of BCG scars, age, sex) affecting tuberculin reactivity. It was also aimed to determine the annual risk of tuberculosis infection (ARTI). The study which was a cross-sectional epidemiological one, was carried out during July 2006-January 2007 in Antalya district center and the number of objects to be applied with TST was determined by Power analysis method. A total of 408 participants; 147 children aged 5-7, 165 young adults aged 14-25 and 96 elderly people aged over 60, were included to the study. TST was applied by Mantoux method using 0.1 ml of purified protein derivative (PPD) RT 23/tween 80 antigen containing 5 tuberculin unit (TU). Evaluation of the test is done according to the domestic tuberculin skin test evaluation criteria. It was determined that 83.5% (341/408) of the cases were vaccinated with BCG and the diameter of TST was significantly higher in the vaccinated group when compared to the unvaccinated group (p= 0.005). Mean tuberculin reactivity (diameter of the TST induration) was 2.70 +/- 2.96 mm in 5-7 years age group, 6.44 +/- 4.11 mm in 4-25 years age group and 4.48 +/- 3.72 mm in > or = 60 years age group. Mean TST diameter was statistically significantly higher in 14-25 years age groups compared to 5-7 years (p= 0.003) and > or = 60 years (p= 0.002) age groups. Among the BCG unvaccinated group TST positivity was none in 5-7 years, 2% in 14-25 years and 7% in > or = 60 years age group. These rates were none in 5-7 and > or = 60 years age groups and 1% in 14-25 years age group in the BCG vaccinated population. It was also observed that TST diameters increased with increasing number of BCG scars and there was no difference in sex dependent TST reactivity. Average ARTI was determined to be 6%. It was concluded that to determine the risk of tuberculosis, annual variation in the ratio of ARTI has to be determined by nationwide evaluation of tuberculin skin test.

摘要

结核菌素皮肤试验(TST)用于结核病的诊断以及潜伏性结核病例的评估,是一种易于实施、可重复且成本低廉的检测方法。本研究旨在确定接种卡介苗和未接种卡介苗人群的结核菌素反应性,调查影响结核菌素反应性的变量(卡介苗接种、卡介苗疤痕数量、年龄、性别)。同时还旨在确定结核病感染的年度风险(ARTI)。该研究为横断面流行病学研究,于2006年7月至2007年1月在安塔利亚地区中心开展,采用功效分析方法确定进行TST检测的对象数量。共有408名参与者纳入研究,其中147名5 - 7岁儿童,165名14 - 25岁青年成人以及96名60岁以上老年人。采用曼托试验法,使用0.1ml含5结核菌素单位(TU)的纯化蛋白衍生物(PPD)RT 23/吐温80抗原进行TST检测。根据国内结核菌素皮肤试验评估标准对检测结果进行评估。结果显示,83.5%(341/408)的病例接种过卡介苗,接种组的TST直径显著高于未接种组(p = 0.005)。5 - 7岁年龄组的平均结核菌素反应性(TST硬结直径)为2.70 +/- 2.96mm,14 - 25岁年龄组为6.44 +/- 4.11mm,60岁及以上年龄组为4.48 +/- 3.72mm。14 - 25岁年龄组的平均TST直径在统计学上显著高于5 - 7岁(p = 0.003)和60岁及以上(p = 0.002)年龄组。在未接种卡介苗组中,5 - 7岁年龄组TST阳性率为零,14 - 25岁年龄组为2%,60岁及以上年龄组为7%。在接种卡介苗人群中,5 - 7岁和60岁及以上年龄组的这些比率为零,14 - 25岁年龄组为1%。还观察到TST直径随着卡介苗疤痕数量的增加而增大,且TST反应性在性别上无差异。平均ARTI确定为6%。研究得出结论,为确定结核病风险,必须通过全国范围内的结核菌素皮肤试验评估来确定ARTI比率的年度变化情况。

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