Adeyekun A A, Egbagbe E E, Oni O A
Department of Radiology, University of Benin Teaching Hospital, Benin-City, Nigeria.
Ann Afr Med. 2010 Jul-Sep;9(3):159-63. doi: 10.4103/1596-3519.68364.
Pulmonary tuberculosis (PTB) remains a scourge in most developing countries. Mantoux skin test and more commonly chest radiography are some of the methods of diagnosing the disease, especially with regard to contact tracing and pre-employment screening. Regular use of radiography has both safety and cost implications. This study aimed at establishing if any justification exists in requesting for chest radiographs in asymptomatic subjects with a positive Mantoux skin test reaction.
174 adults comprising PTB contacts and newly employed/admitted university staff/students were recruited into the study. They were 89 males (51.1%) and 85 females (48.9%). All subjects had Mantoux test (using purified protein derivative, PPD). Patients who had positive Mantoux reaction subsequently were subjected to posteroanterior chest radiographic examination. Mantoux test and chest radiographic findings were then correlated with each other.
102 subjects (59.2%) had positive Mantoux reactions, while 27 subjects (31.1%) had abnormal chest radiographs. There was no significant correlation between Mantoux readings and chest radiographic findings (P=0.106).
It is concluded that other ancillary tests like sputum examination and/or, where available, Interferon and ESAT tests should be carried out before chest radiograph is requested in subjects with positive Mantoux reaction.
在大多数发展中国家，肺结核（PTB）仍然是一大祸害。结核菌素皮肤试验以及更常用的胸部X光检查是诊断该疾病的一些方法，特别是在接触者追踪和入职前筛查方面。定期进行X光检查存在安全性和成本方面的问题。本研究旨在确定对于结核菌素皮肤试验反应呈阳性的无症状受试者，要求进行胸部X光检查是否有任何正当理由。
174名成年人被纳入研究，包括肺结核接触者以及新入职/录取的大学教职员工/学生。其中男性89名（51.1%），女性85名（48.9%）。所有受试者均进行了结核菌素试验（使用纯化蛋白衍生物，PPD）。结核菌素试验呈阳性的患者随后接受了后前位胸部X光检查。然后将结核菌素试验结果与胸部X光检查结果进行相互关联分析。
102名受试者（59.2%）结核菌素试验呈阳性，而27名受试者（31.1%）胸部X光检查结果异常。结核菌素试验读数与胸部X光检查结果之间无显著相关性（P = 0.106）。
得出的结论是，对于结核菌素试验呈阳性的受试者，在要求进行胸部X光检查之前，应先进行其他辅助检查，如痰液检查和/或（如有条件）干扰素和ESAT检测。
