[儿童结核病的预防、检测、诊断和治疗新技术]。

Problemy tuberkuleza Pub Date : 2003-01-01
L A Mitinskaia
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引用次数: 0

摘要

在流行病学形势紧张的情况下,应开发和应用新技术,提高儿童结核病的具体预防、早期发现、诊断和治疗效率。有证据表明,与未接种疫苗的儿童相比,低抗原负荷的BGC - m疫苗具有高效率和低反应原性,可使婴儿发病率降低15倍,与BGC疫苗相比,该疫苗接种后并发症减少5倍。26年来,在儿童和青少年大规模接种疫苗期间,通过Mantoux试验和2TE PPD-L进行结核菌素诊断,证明了其在早期识别结核病和危险人群方面的作用。一个新的风险群体已经被确定。这包括结核菌素反应增加的儿童;三个月的异烟肼间歇化学预防可降低儿童对结核菌素的敏感性,预防儿童患结核病。学龄前儿童和学龄儿童使用药物(异烟肼+利福平+吡嗪酰胺)进行短期(6-9个月)化疗,分别在83%和60%的合并并发症儿童中获得最佳愈合,无无并发症结核残留改变。化疗方案被分为4组不同的剂量方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[New technologies in the prevention, detection, diagnosis and treatment of tuberculosis in children].

If the epidemiological situation is tense, new technologies should be developed and put into practice to enhance the efficiency of specific prevention, early detection, diagnosis and treatment of tuberculosis in children. There is evidence for the high efficacy and low reactogenicity of lower antigenicity-loading BCG-M vaccine that causes a 15-fold decrease in infant morbidity, as compared with that among non-vaccinated children, and this vaccine shows a 5-fold reduction in postvaccination complications as compared with BGC vaccine. The 26-year use of tuberculin diagnosis via Mantoux test with 2TE PPD-L during mass vaccination of children and adolescents has proved itself in early identification of tuberculosis and risk groups. A new risk group has been identified. This includes children with increasing tuberculin reactions; three-month intermittent chemoprevention with isoniazid reduces tuberculin sensitivity in the children and prevents tuberculosis in them. The developed short-term (6-9 months) courses of chemotherapy in preschool and school children by using drugs (isoniazid + rifampicin + pyrazinamide) yield the best healing without residual changes of uncomplicated forms of tuberculosis in 83 and 60% of the children with complicated events, respectively. The chemotherapy regimens have been divided into 4 groups of different dosage schedules.

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