Slutkin G, Perez-Stable E J, Hopewell P C
Am Rev Respir Dis. 1986 Nov;134(5):1048-51. doi: 10.1164/arrd.1986.134.5.1048.
To determine the optimal strategy for tuberculin testing in elderly persons, we examined two aspects of the test: (1) the concordance between tuberculin skin test readings 2 and 7 days after application, and (2) the frequency of boosting of nonsignificant reactions. Four hundred eleven nursing home residents (mean age 74.5 yr) were tested. Significant reactions (greater than or equal to 10 mm of induration to 5TU PPD) were found in 133 (32%) subjects on day 2. Men, nonwhites, and persons younger than 75 yr of age had an increased proportion of significant reactions (p less than 0.01). Tuberculin reactivity steadily declined in persons between 75 and 90 yr of age but was increased among persons age 90 to 101 yr of age. Of 380 subjects with readings on both day 2 and day 7, 96 (25%) had significant reactions on both, 23 (6%) had indurations greater than or equal to 10 mm on day 2 only, and 20 (5%) had indurations greater than or equal to 10 mm on day 7 only. Repeat testing found an additional 14 subjects whose reactions increased from less than 10 mm to greater than or equal to 10 mm (booster effect). This evaluation indicates that the most sensitive and efficient strategy for tuberculin testing consists of a single reading at day 7 followed by a second test with a reading in 48 h for persons with reactions less than 10 mm.
为确定老年人结核菌素试验的最佳策略，我们研究了该试验的两个方面：（1）应用结核菌素皮肤试验后第2天和第7天读数的一致性，以及（2）无显著反应的增强频率。对411名养老院居民（平均年龄74.5岁）进行了检测。第2天，133名（32%）受试者出现显著反应（对5TU PPD硬结大于或等于10mm）。男性、非白种人和年龄小于75岁的人出现显著反应的比例增加（p<0.01）。75至90岁人群的结核菌素反应性稳步下降，但90至101岁人群的反应性增加。在第2天和第7天均有读数的380名受试者中，96名（25%）两天均出现显著反应，23名（6%）仅在第2天硬结大于或等于10mm，20名（5%）仅在第7天硬结大于或等于10mm。重复检测发现另外14名受试者的反应从小于10mm增加到大于或等于10mm（增强效应）。该评估表明，结核菌素试验最敏感和有效的策略包括在第7天进行单次读数，然后对反应小于10mm的人在48小时后进行第二次检测并读数。
