Karkucak M, Capkin E, Ozsu S, Nuhoglu I, Erol M, Yilmaz G, Gokmen F
Department of Physical Medicine and Rehabilitation, Medical Faculty, Karadeniz Technical University, Turkey.
Bratisl Lek Listy. 2010;111(9):498-501.
The tuberculin skin test (TST) has recently been proposed as a screening procedure for latent TB prior to anti-tumor necrosis factor (TNF) alpha therapy. Our aim was to evaluate TST levels in patients receiving anti TNF alpha due to ankylosing spondylitis (AS) and rheumatoid arthritis (RA).
73 AS patients (52 male, 21 female) and 33 RA patients (11 male, 22 female) were enrolled in the study. Patients' clinical and demographic characteristics were recorded. Average age +/- standard deviation was 38.8 +/- 7.2 years for AS and 40.7 +/- 13 for RA. Median number of immunosuppressive agents used was 1 (min-max) (0-2) in AS and 2 (2-3) in RA. To determine the activity of the disease, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) was measured in AS patients, and DAS 28 (Disease Activity Index) was used in RA patients. TST was performed using the Mantoux method in all patients.
Mean BASDAI was 5.1 +/- 0.8 in AS, and DAS 28 score in RA was 5.7 +/- 0.5. Both, AS and RA patients had active disease. TST values were higher in AS than in RA patients. TST values were 11.5 +/- 6.5 mm in AS patients, compared to 7.0 +/- 6.4 mm in RA patients. A positive correlation between disease duration and TST was determined in AS patients. There was also a weak correlation in RA patients between immunosuppressive use and TST (r = 0.37, p = 0.032). No correlation was determined with disease activation in AS or RA patients.
This is the first study to evaluate the correlation between the use of multiple immunosuppressive agents and TST. We determined that TST is correlated with disease duration in AS and with the use of multiple immunosuppressive agents in RA (Tab. 3, Ref. 21).
结核菌素皮肤试验（TST）最近被提议作为在抗肿瘤坏死因子（TNF）α治疗前筛查潜伏性结核的一种方法。我们的目的是评估因强直性脊柱炎（AS）和类风湿关节炎（RA）而接受抗TNFα治疗的患者的TST水平。
本研究纳入了73例AS患者（52例男性，21例女性）和33例RA患者（11例男性，22例女性）。记录患者的临床和人口统计学特征。AS患者的平均年龄±标准差为38.8±7.2岁，RA患者为40.7±13岁。AS患者使用免疫抑制剂的中位数为1（最小值 - 最大值）（0 - 2），RA患者为2（2 - 3）。为确定疾病活动度，对AS患者测量巴氏强直性脊柱炎疾病活动指数（BASDAI），对RA患者使用28关节疾病活动指数（DAS 28）。所有患者均采用曼托试验法进行TST检测。
AS患者的平均BASDAI为5.1±0.8，RA患者的DAS 28评分为5.7±0.5。AS和RA患者均患有活动性疾病。AS患者的TST值高于RA患者。AS患者的TST值为11.5±6.5毫米，而RA患者为7.0±6.4毫米。在AS患者中确定疾病持续时间与TST之间存在正相关。在RA患者中，免疫抑制剂的使用与TST之间也存在弱相关性（r = 0.37，p = 0.032）。未确定与AS或RA患者的疾病活动存在相关性。
这是第一项评估多种免疫抑制剂的使用与TST之间相关性的研究。我们确定TST与AS的疾病持续时间以及RA中多种免疫抑制剂的使用相关（表3，参考文献21）。
