Harada Y, Harada S, Kajiki A, Kitahara Y, Takamoto M, Ishibashi T
Department of Internal Medicine, National Ohmuta Hospital, Fukuoka, Japan.
Kekkaku. 1998 May;73(5):349-53.
This study was carried out to clarify the diagnostic usefulness of the skin tests of purified protein derivatives from M. intracellulare (PPD-B) and M. tuberculosis (PPDs). Study subjects consisted of 41 patients with primary infection type of M. avium complex (MAC) disease, 36 patients with pulmonary tuberculosis (TB) and 29 patients with other bacterial respiratory infections including COPD (OB). The patients were sorted out to middle (50-69 y.o.) and old (70-89 y.o.) age groups of each disease. The size of skin redness elicited 48 hours after the PPD-B and PPDs intradermal injections were compared among them. The results were as follows. 1) Both PPD-B and PPDs skin reactions were larger in the middle age group than in the old one for each disease. 2) In PPDs skin tests, the reaction of TB group was the largest among the three diseases. In PPD-B skin tests, that of MAC was the largest. 3) In TB group, PPDs skin reaction was significantly larger than that of PPD-B, while in MAC and OB groups there was no significant difference between the skin reactions of PPDs and PPD-B. 4) Defining significant positive reaction to PPD-B as PPD-B skin reaction exceeding 10 mm and larger than that of PPDs skin reaction, the rate of significant positive reaction to PPD-B was significantly higher in MAC than TB in both age groups. These results showed that the simultaneous skin tests of PPD-B and PPDs were a useful aid in the diagnosis of MAC infection disease when mycobacterial infection diseases were clinically suspected by bacteriological or chest radiographic examinations.
本研究旨在阐明胞内分枝杆菌纯化蛋白衍生物（PPD-B）和结核分枝杆菌纯化蛋白衍生物（PPDs）皮肤试验的诊断价值。研究对象包括41例鸟分枝杆菌复合群（MAC）疾病原发性感染型患者、36例肺结核（TB）患者和29例包括慢性阻塞性肺疾病（COPD）在内的其他细菌性呼吸道感染患者（OB）。将患者按每种疾病分为中年（50 - 69岁）和老年（70 - 89岁）年龄组。比较PPD-B和PPDs皮内注射48小时后引起的皮肤发红大小。结果如下：1）每种疾病中，中年组的PPD-B和PPDs皮肤反应均大于老年组。2）在PPDs皮肤试验中，TB组的反应在三种疾病中最大。在PPD-B皮肤试验中，MAC组的反应最大。3）在TB组中，PPDs皮肤反应明显大于PPD-B，而在MAC组和OB组中，PPDs与PPD-B的皮肤反应无显著差异。4）将PPD-B皮肤反应超过10 mm且大于PPDs皮肤反应定义为对PPD-B的显著阳性反应，在两个年龄组中，MAC组对PPD-B的显著阳性反应率均显著高于TB组。这些结果表明，当通过细菌学或胸部影像学检查临床怀疑有分枝杆菌感染疾病时，同时进行PPD-B和PPDs皮肤试验有助于MAC感染疾病的诊断。
