Agarwal Shweta, Das Siddharth Kumar, Agarwal Girdhar G, Srivastava Ragini
Department of Rheumatology, King George Medical University, Lucknow, Uttar Pradesh 226018, India.
Department of Statistics, Lucknow University, Lucknow 226007, India.
Interdiscip Perspect Infect Dis. 2014;2014:430134. doi: 10.1155/2014/430134. Epub 2014 Feb 24.
Tuberculin skin test has been used as an indicator of latent tuberculosis in patients with Rheumatoid Arthritis (RA) before administration of biologicals. Effect of Disease modifying antirheumatic drugs (DMARDs) and steroids on the result of tuberculin skin test (TST) may have important implications in interpretation of results of this test. Objectives. To find the prevalence of positive TST in rheumatoid patients and the effect of standard treatment on the results of TST. Method. In this cross-sectional study two hundred and fifty patients of RA above 18 years of age, classified using 1987 ACR criteria for RA, were enrolled from rheumatology outdoor. Demographics, disease activity, disease duration, and therapy were recorded. All patients underwent TST. Results. Fifty-one (20.4%) patients were found to be tuberculin positive. Tuberculin positivity was not affected by MTX intake but it was significantly low in patients with recent steroid intake as compared to patients who had not taken steroids in last 3 months (3% versus 25%, P = 0.002). Conclusion. Prevalence of tuberculin positivity in patients with RA was found to be low. Results were not affected by methotrexate; however tuberculin skin test results in patients with recent use of steroids are likely to be negative.
在使用生物制剂之前，结核菌素皮肤试验已被用作类风湿关节炎（RA）患者潜伏性结核的指标。改善病情抗风湿药物（DMARDs）和类固醇对结核菌素皮肤试验（TST）结果的影响可能对该试验结果的解读具有重要意义。目的。了解类风湿患者中TST阳性的患病率以及标准治疗对TST结果的影响。方法。在这项横断面研究中，从风湿病门诊招募了250名年龄在18岁以上、根据1987年美国风湿病学会（ACR）类风湿关节炎标准分类的RA患者。记录人口统计学资料、疾病活动度、病程和治疗情况。所有患者均接受TST。结果。发现51名（20.4%）患者结核菌素呈阳性。结核菌素阳性不受甲氨蝶呤摄入的影响，但与过去3个月未服用类固醇的患者相比，近期服用类固醇的患者结核菌素阳性率显著较低（3%对25%，P = 0.002）。结论。发现RA患者中结核菌素阳性的患病率较低。结果不受甲氨蝶呤的影响；然而，近期使用类固醇的患者结核菌素皮肤试验结果可能为阴性。
