Seth V, Singhal P K, Semwal O P, Kabra S K, Jain Y
Department of Pediatrics, Ail India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Indian Pediatr. 1993 Apr;30(4):479-85.
One hundred and ninety six children (age group 6 months to 12 years) attending the Pediatric Tuberculosis Clinic at AIIMS, New Delhi, over a period from January 1988 to December 1989 were analysed. Nearly 61% of children were malnourished (Grades III and IV). A positive family history was noted in nearly one third (33.7%) of cases while 41.3% of children had received BCG. A positive Mantoux test was noted in 77% of cases. The most prominent lesion on radiology was parenchymal (51.4%). In nearly two third of cases, both Mantoux test and X-ray chest was positive. A family history of tuberculosis and BCG vaccination was significantly associated with positive Mantoux test (p < 0.01). Fever and cough in older children (> 6 years) while weight loss in younger children (< 3 years) were the predominant symptoms. Most of the cases (82.1%) had pulmonary primary complex, the proportion being higher in older age group. The severe form of tuberculosis, i.e., progressive primary disease, military tuberculosis, etc., were significantly more in younger children. The various risk factors significantly associated with severe form of tuberculosis were very young children (< 3 years), no BCG vaccination, a negative family history and a negative Mantoux test.
对1988年1月至1989年12月期间在新德里全印医学科学研究所儿科结核病诊所就诊的196名儿童（年龄在6个月至12岁之间）进行了分析。近61%的儿童营养不良（Ⅲ级和Ⅳ级）。近三分之一（33.7%）的病例有阳性家族史，而41.3%的儿童接种过卡介苗。77%的病例结核菌素试验呈阳性。放射学上最突出的病变是实质性病变（51.4%）。近三分之二的病例中，结核菌素试验和胸部X线检查均为阳性。结核病家族史和卡介苗接种与结核菌素试验阳性显著相关（p<0.01）。年龄较大的儿童（>6岁）出现发热和咳嗽，而年龄较小的儿童（<3岁）出现体重减轻是主要症状。大多数病例（82.1%）患有原发性肺结核，在年龄较大的组中比例更高。严重形式的结核病，即进行性原发性疾病、粟粒性结核病等，在年龄较小的儿童中明显更多。与严重形式的结核病显著相关的各种危险因素是年龄非常小的儿童（<3岁）、未接种卡介苗、阴性家族史和结核菌素试验阴性。
