Tournier G
Service de pédiatrie et pneumologie de l'enfant, hôpital Trousseau, Paris.
Rev Prat. 1990 Mar 11;40(8):725-9.
The only available method for quantitative exploration of skin allergy to tuberculin is intradermal injection, since there is no other satisfactory method to evaluate the induration observed. Below 5 mm the induration has no significance. Between 5 and 10 mm it corresponds to an allergic reaction induced by BCG vaccine or by usually inapparent infections due to atypical mycobacteria. A diameter of 10 mm or more suggests either M. tuberculosis infection or allergy to BCG. The intensity of allergic reaction varies under the influence of numerous factors which may be genetic or nutritional, or associated with viral infections, antiviral vaccines and medicinal treatments. Exploring this allergy is of interest on the scores: (1) for epidemiological purposes, to obtain information on the annual risk tuberculosis infection or on the quality of the protection conferred by the vaccine in a given population; (2) for diagnostic purposes, to detect tuberculosis, and especially primary tuberculosis in children; (3) for vaccinal purposes, to determine the limitation of BCG. In subjects who have been vaccinated tuberculosis is rare but remains possible, and in such cases reactions to tuberculin may be difficult or even impossible to interpret.
对结核菌素皮肤过敏进行定量检测的唯一可行方法是皮内注射，因为没有其他令人满意的方法来评估所观察到的硬结。硬结小于5毫米没有意义。5至10毫米之间的硬结对应于卡介苗或非典型分枝杆菌通常引起的不明显感染所诱发的过敏反应。直径10毫米或更大提示结核分枝杆菌感染或对卡介苗过敏。过敏反应的强度受多种因素影响，这些因素可能是遗传、营养方面的，或与病毒感染、抗病毒疫苗及药物治疗有关。探究这种过敏反应有以下几方面意义：（1）出于流行病学目的，获取特定人群中每年结核感染风险或疫苗所提供保护质量的信息；（2）出于诊断目的，检测结核病，尤其是儿童原发性结核病；（3）出于疫苗接种目的，确定卡介苗的局限性。在已接种疫苗的人群中，结核病虽罕见但仍有可能发生，在这种情况下，对结核菌素的反应可能难以甚至无法解读。
