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潜伏性结核感染的诊断与治疗

Diagnosis and treatment of latent tuberculosis infection.

作者信息

Lee Seung Heon

机构信息

Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

出版信息

Tuberc Respir Dis (Seoul). 2015 Apr;78(2):56-63. doi: 10.4046/trd.2015.78.2.56. Epub 2015 Apr 2.

Abstract

A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

摘要

少数存活的结核杆菌可存在于潜伏性结核感染(LTBI)个体中,这些个体没有明显的临床症状或胸部X光片异常。LTBI的诊断和治疗对于公共卫生和私人医疗中的结核病(TB)控制非常重要,尤其是在高危人群中。2014年更新的韩国结核病指南建议,可根据宿主的年龄、免疫状态以及结核病接触史,使用结核菌素皮肤试验、干扰素-γ释放试验或两者结合来诊断LTBI。LTBI治疗方案包括异烟肼、利福平或异烟肼/利福平。然而,在为近期接触者选择合适药物时,必须考虑索引病例的药敏试验结果。基于2014年新指南的标准化LTBI诊断和治疗将有助于韩国有效控制结核病,并有助于制定更新的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2bd/4388901/1c6c714758ca/trd-78-56-g001.jpg

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