应用结核菌素皮肤试验评价血液透析患者潜伏性结核感染的流行

IF 0.2 Q4 UROLOGY & NEPHROLOGY
Azita Zafar Mohtashami, A. Amiri, B. Hadian, Pardis Nasiri
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引用次数: 2

摘要

引言:接受透析的患者患有一定程度的细胞免疫损伤,这使他们容易发展为潜伏性结核病感染(LTBI),从而转变为活动性结核病(TB)。诊断透析患者的LTBI有助于预防疾病的发展。目的:本研究的目的是评估一组血液透析患者中LTBI的频率。患者和方法:我们研究了在Khorramabad教学医院接受血液透析的所有患者。通过观察和访谈完成问卷调查来收集数据。进行Mantoux结核菌素皮肤试验(TST),然后在48至72小时后,以毫米为单位测量硬结。等于或大于10mm的结果被认为是阳性的。结果:119名接受血液透析的患者参与了这项研究。本研究患者的平均年龄为58.55±16.04岁。97名患者(81.5%)TST部位的硬结大小等于或大于10mm,22名患者(18.5%)小于10mm。超过81%的参与者患有LTBI。直到大约两年后,没有人在没有预防性治疗的情况下患上活动性肺结核。结论:多项研究表明血液透析患者TST结果存在不确定性。82%的阳性率太高了,很难将所有的阳性率都视为真正的阳性。因此,决定开始预防性治疗将是一项挑战。我们建议世界卫生组织(世界卫生组织)将重点放在一种新的负担得起、可获得的有效LTBI筛查测试上,这种测试不需要重复或通过其他诊断方法进行确认,特别是在未来扩大普通人群筛查时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of the prevalence of latent tuberculosis infection in hemodialysis patients using tuberculin skin test
Introduction: Patients undergoing dialysis are suffering from some degree of cellular immunity impairment which predispose them to develop latent tuberculosis infection (LTBI) which can turn into active tuberculosis (TB). Diagnosing LTBI in dialysis patients is helpful in preventing disease evolution. Objectives: The aim of this study was to estimate the frequency of LTBI in a group of hemodialysis patients. Patients and Methods: We studied all patients undergoing hemodialysis in Khorramabad teaching hospitals. Data were collected by completing a questionnaire through observation and interview. The Mantoux tuberculin skin test (TST) was performed, then 48 to 72 hours later, the induration was measured in millimeters. Results equal to or greater than 10 mm were considered positive. Results: One hundred and nineteen patients undergoing hemodialysis participated in the study. The mean age of patients in this study was 58.55 ± 16.04 years. The induration size at the TST site was equal to or greater than 10 mm for 97 patients (81.5%) and less than 10 mm for 22 patients (18.5%). More than 81% of participants had LTBI. Until about two years later, none developed active tuberculosis without preventive treatment. Conclusion: Several studies indicate the uncertainty of TST results in hemodialysis patients. Eighty-two percent positive is too much, and makes it difficult to consider all of them to be true positives. Therefore, it will be challenging to decide on starting preventive treatment. We recommend World Health Organization (WHO) to focus on a new affordable accessible efficient test for LTBI screening which does not require to be repeated or be confirmed by another diagnostic method, especially, for the expanded screening of the general population in the future.
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来源期刊
Journal of Renal Injury Prevention
Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-
CiteScore
1.60
自引率
0.00%
发文量
36
期刊介绍: The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.
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