静脉吸毒者胸部X光异常：对结核病筛查项目的影响。
Abnormal chest x-rays in intravenous drug users: implications for tuberculosis screening programs.
作者信息
Bellin E, Fletcher D, Safyer S
机构信息
Montefiore-Rikers Island Health Service, East Elmhurst, NY 11370.
出版信息
Am J Public Health. 1993 May;83(5):698-700. doi: 10.2105/ajph.83.5.698.
OBJECTIVES
The purpose of the study was to (1) determine the prevalence of significant abnormalities in routine chest x-rays used to screen for pulmonary tuberculosis in intravenous drug users and (2) evaluate the ability of the purified protein derivative skin test to identify persons with such abnormalities.
METHODS
We conducted a cross-sectional screening study on 1314 persons admitted to an opiate detoxification unit in an urban jail. Purified protein derivative tuberculin reactivity and the prevalence of abnormalities consistent with tuberculosis on screening chest x-rays were evaluated. The chest x-ray was obtained independent of the skin test.
RESULTS
The chest x-rays of 73 of the inmates (5.6%) showed abnormalities consistent with tuberculosis. Tuberculin skin testing missed 17 of 26 chest x-rays (65%) with significant infiltrates.
CONCLUSIONS
Purified protein derivative screening is insensitive to chest x-ray abnormalities that require additional diagnostic evaluation for tuberculosis. Routine chest studies should be performed on all intravenous drug users admitted to congregate housing settings.
目的
本研究的目的是：（1）确定用于筛查静脉吸毒者肺结核的常规胸部X光片中显著异常的患病率；（2）评估纯化蛋白衍生物皮肤试验识别有此类异常者的能力。
方法
我们对一所城市监狱中收治的1314名接受阿片类药物戒毒治疗的人员进行了一项横断面筛查研究。评估了纯化蛋白衍生物结核菌素反应性以及筛查胸部X光片中与结核病相符的异常患病率。胸部X光片的获取与皮肤试验无关。
结果
73名囚犯（5.6%）的胸部X光片显示有与结核病相符的异常。结核菌素皮肤试验漏检了26张有显著浸润的胸部X光片中的17张（65%）。
结论
纯化蛋白衍生物筛查对需要进一步进行结核病诊断评估的胸部X光片异常不敏感。应对所有入住集体居住场所的静脉吸毒者进行常规胸部检查。
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