Lung Allergi Kliniken, Karolinska University Hospital, Stockholm, Sweden.
Curr Opin Pulm Med. 2012 May;18(3):233-40. doi: 10.1097/MCP.0b013e328351f9d6.
Tuberculosis (TB) remains a global emergency and continues to kill 1.4 million people every year. The interaction between noncommunicable and infectious diseases like TB has important implications with regard to the attainment of the Millennium Development Goals (MDGs). Smoking, diabetes mellitus, anti-TNFα drugs and other immunosuppressive therapies are well known major risk factors associated with TB. The purpose of this review is to summarize the recent literature on these risk factors and interventions that reduce the risk.
Mathematical models and aggregate data from the field show that smoking, diabetes and anti-TNFα drugs independently increase the risk of developing active TB. There is consensus on the great need for screening for active TB disease in patients with these conditions and targeted preventive interventions through a combined multidisciplinary approach.
Smoking, diabetes mellitus, anti-TNFα drugs and new immunosuppressive treatments represent important common risk factors for TB. A high degree of clinical awareness of the possibility of TB should be considered in patients with these risk factors, and active screening and prevention should be undertaken. Further operational research is needed to optimize screening for latent Mycobacterium tuberculosis infection, instituting preventive intervention measures.
结核病（TB）仍然是一个全球性的紧急情况，每年仍有 140 万人因此死亡。非传染性疾病与结核病等传染病之间的相互作用对实现千年发展目标（MDGs）具有重要意义。吸烟、糖尿病、抗 TNF-α 药物和其他免疫抑制疗法是众所周知的与结核病相关的主要危险因素。本文综述的目的是总结这些危险因素以及降低风险的干预措施的最新文献。
数学模型和来自该领域的汇总数据表明，吸烟、糖尿病和抗 TNF-α 药物独立地增加了发生活动性结核病的风险。人们普遍认识到，非常有必要对这些患者进行活动性结核病筛查，并通过综合多学科方法进行有针对性的预防干预。
吸烟、糖尿病、抗 TNF-α 药物和新的免疫抑制治疗代表了结核病的重要共同危险因素。对于具有这些危险因素的患者，应高度重视发生结核病的可能性，并进行主动筛查和预防。需要进一步开展业务研究，以优化潜伏性结核分枝杆菌感染的筛查，并实施预防干预措施。
