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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (1): 91-95.doi: 10.3969/j.issn.1000-6621.2021.01.017

• 综述 • 上一篇    下一篇

潜伏性结核感染诊治进展

李果, 庞先琼, 徐华, 敬明燕, 范庞双, 陈绍平()   

  1. 637200 四川省西充县人民医院呼吸与危重症医学科(李果、庞先琼、徐华、敬明燕、范庞双);川北医学院附属医院呼吸与危重症医学科(陈绍平)
  • 收稿日期:2020-09-28 出版日期:2021-01-10 发布日期:2021-01-12
  • 通信作者: 陈绍平 E-mail:chenshaoping836@163.com
  • 基金资助:
    四川省基层卫生事业发展研究中心资助项目(SWFZ20-C-077)

Progress in diagnosis and treatment of latent tuberculosis infection

LI Guo, PANG Xian-qiong, XU Hua, JING Ming-yan, FAN Pang-shuang, CHEN Shao-ping()   

  1. Department of Respiratory and Critical Care Medicine, Xichong County People’s Hospital, Nanchong 637200, China
  • Received:2020-09-28 Online:2021-01-10 Published:2021-01-12
  • Contact: CHEN Shao-ping E-mail:chenshaoping836@163.com

摘要:

潜伏性结核感染(latent tuberculosis infection,LTBI)是一种对结核分枝杆菌抗原刺激产生持续免疫反应的状态,因其有进展为活动性结核病的风险,在世界范围内越来越受到重视。LTBI的筛查和预防性治疗是结核病综合防控工作的重要组成部分,但目前尚无LTBI的直接诊断方法和统一的治疗方案。除结核菌素皮肤试验和γ-干扰素释放试验两种常规检测方法外,我国新研发的重组结核杆菌融合蛋白(EC)[该制品名称是国家药典委员会确定的药品中文通用名称,“EC”为重组融合蛋白“结核分枝杆菌早期分泌性抗原靶6(ESAT-6)和培养滤液蛋白10(CFP-10)”]也可用于检测LTBI。异烟肼单药预防性治疗是目前应用最为广泛的方案,但含利福霉素的治疗方案因疗程较短,依从性较高,优势更明显。现阶段我国在LTBI领域的研究相对较少,预防性治疗覆盖率低,应积极开展LTBI相关研究,探索符合国情的预防性治疗方案。

关键词: 潜伏性结核感染, 诊断, 综合预防, 预防和防护用药, 综述文献(主题)

Abstract:

Latent tuberculosis infection (LTBI) is a status of persistent immune response to stimulation by Mycobacterium tuberculosis antigens. Because of the risk of developing active tuberculosis, LTBI has been paid more and more attentions worldwide. The screening and preventive treatment of LTBI is an important component in the comprehensive prevention and control program of tuberculosis. However, there is no direct diagnosis method and unified treatment regimen for LTBI. In addition to the two conventional methods using for LTBI screening, tuberculin skin test and interferon gamma release assays, a newly developed method of recombinant Mycobacterium tuberculosis fusion protein (EC) (The generic name in Chinese of this product determined by the Chinese Pharmacopoeia Committee is used. “EC” is the recombinant fusion protein of “early secretory antigenic target-6 (ESAT-6) and culture filtrate protein 10 (CFP-10)”) can also be used in China. Currently, the preventive treatment with single-drug isoniazid is the most widely used regimen, but the regimen with rifamycin has more obvious advantages due to the shorter treatment duration and higher treatment compliance. So far, there are relatively few studies in the field of LTBI in China, and the coverage rate of preventive treatment for LTBI is low. Researchers related to LTBI should be conducted actively to explore the preventive treatment regimen in line with national conditions.

Key words: Latent tuberculosis infection, Diagnosis, Universal precautions, Protective agents, Review literature as topic