Aydoğan Oznur, Gürgün Alev, Başoğlu Ozen Kaçmaz, Aşçi Gülay, Ertilav Muhittin, Bacakoğlu Feza, Töz Hüseyin, Güzelant Asuman, Sayiner Abdullah
Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey.
Tuberk Toraks. 2009;57(3):268-76.
The aim of this study was to evaluate the response of tuberculin skin test (TST) and the parameters that affect the response in patients with chronic renal failure (CRF) on different treatment regimens. The study population consisted of 150 patients (78 females, mean age 48.1 + or - 16.7 years, the mean disease duration 6.6 + or - 6.1 years). Of these patients, 50 were on haemodialysis (HD), 50 were renal transplant patients, 26 were on peritoneal dialysis (PD) and 24 were treated medically. TST was performed to all patients, an induration with a diameter of 10 mm or more was accepted as positive response in HD, PD, medical treatment groups, whereas 5 mm or more was considered as positive in transplant group. TST was positive in 52% of the study population (56% in HD group, 54% in PD group, 44% in transplant group, 58% in medical treatment group, p> 0.05). There was a positive correlation between TST and age in patients older than 60 of transplant and medical treatment groups (p= 0.008). In HD patients with negative TST, the number of female patients was higher (p= 0.02). In transplant patients with positive TST, duration of HD was shorter (p= 0.01), the blood urea level was lower (p= 0.04), hemoglobin level was higher (p= 0.04). The ratio of negative TST was higher (p< 0.05), TST reactivity was smaller (p= 0.01) in only transplant patients with no BCG scar. The number of BCG scar was correlated positively with TST (p= 0.04). In the medical treatment group, patients with positive TST response were older (p= 0.02) and in PD group the tuberculin reactivity was not affected by any of the patient-related parameters. It must be considered that the response to TST is low in young patients with uncontrolled CRF and under immunosuppressive therapy.
本研究的目的是评估慢性肾衰竭(CRF)患者在不同治疗方案下结核菌素皮肤试验(TST)的反应以及影响该反应的参数。研究人群包括150例患者(78例女性,平均年龄48.1±16.7岁,平均病程6.6±6.1年)。其中,50例接受血液透析(HD),50例为肾移植患者,26例接受腹膜透析(PD),24例接受药物治疗。对所有患者进行TST检测,HD组、PD组和药物治疗组中硬结直径10mm或更大被视为阳性反应,而移植组中5mm或更大被视为阳性。TST在52%的研究人群中呈阳性(HD组为56%,PD组为54%,移植组为44%,药物治疗组为58%,p>0.05)。移植组和药物治疗组中60岁以上患者的TST与年龄呈正相关(p=0.008)。TST阴性的HD患者中女性患者数量较多(p=0.02)。TST阳性的移植患者中,HD持续时间较短(p=0.01),血尿素水平较低(p=0.04),血红蛋白水平较高(p=0.04)。仅在无卡介苗疤痕的移植患者中,TST阴性比例较高(p<0.05),TST反应性较小(p=0.01)。卡介苗疤痕数量与TST呈正相关(p=0.04)。在药物治疗组中,TST反应阳性的患者年龄较大(p=0.02),而在PD组中,结核菌素反应性不受任何患者相关参数的影响。必须考虑到,未控制的CRF年轻患者和接受免疫抑制治疗的患者对TST的反应较低。