结核菌素皮肤试验应用指南

doi:10.19982/j.issn.1000-6621.20260202

摘要/Abstract

摘要：

结核分枝杆菌感染检测是诊断结核分枝杆菌潜伏感染和辅助诊断结核病的重要手段。随着γ-干扰素释放试验和结核分枝杆菌特异抗原皮肤试验等新技术的推广应用,如何进一步规范和高效地应用结核菌素皮肤试验服务我国的结核病防控工作值得探讨。本指南由中国医学科学院结核病研究中心发起,中国防痨协会标准化专业分会、中国防痨协会感染控制专业分会及《中国防痨杂志》编辑委员会共同组织专家制定。专家组基于国内外相关研究进展和临床实践经验,深入探讨了结核菌素皮肤试验在结核病辅助诊断、识别近期感染及指导预防性治疗等方面的应用价值,并提出了相应推荐意见,旨在为结核病防治工作者提供科学、规范的实践指导。

关键词: 分枝杆菌,结核, 结核菌素皮肤试验, 指南

Abstract:

Diagnosis of tuberculosis infection is a critical method for defining latent tuberculosis infection and assisting in the diagnosis of active tuberculosis. With the promotion and application of new technologies such as interferon-gamma release assays and tuberculosis antigen-based skin tests, how to further standardize and efficiently apply the tuberculin skin test (TST) to serve China’s tuberculosis prevention and control efforts is an issue worthy of exploration. This guideline was initiated by the Center for Tuberculosis Research, Chinese Academy of Medical Sciences, and developed by experts organized jointly by the Standardization Professional Branch of the Chinese Antituberculosis Association, the Infection Control Professional Branch of the Chinese Antituberculosis Association, and the Editorial Board of Chinese Journal of Antituberculosis. Based on domestic and international research progress and clinical practice experience, the expert panel thoroughly discussed the application value of TST in the auxiliary diagnosis of tuberculosis, identification of recent infection, and guidance for preventive treatment, and proposed corresponding recommendations, which aims to provide scientific and standardized practical guidance for tuberculosis prevention and control workers.

Key words: Mycobacterium tuberculosis, Tuberculin skin test, Guidebooks

中图分类号:

中国防痨协会标准化专业分会, 中国防痨协会感染控制专业分会, 《中国防痨杂志》编辑委员会. 结核菌素皮肤试验应用指南[J]. 中国防痨杂志, 2026, 48(8): 1083-1095. doi: 10.19982/j.issn.1000-6621.20260202

Standardization Professional Branch of Chinese Antituberculosis Association, Tuberculosis Infect Control Branch of Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis. Guidelines for the application of tuberculin skin test[J]. Chinese Journal of Antituberculosis, 2026, 48(8): 1083-1095. doi: 10.19982/j.issn.1000-6621.20260202

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参考文献 64

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项目	内容
证据质量分级
高级证据(A)	对观察值非常有把握;观察值接近真实值
中级证据(B)	对观察值有中等程度的把握;观察值有可能接近真实值
低级证据(C)	对观察值的把握有限;观察值可能与真实值有很大区别
极低级证据(D)	对观察值几乎无把握;观察值可能与真实值有极大区别
推荐强度分级
强(1)	明确显示干预措施利大于弊或弊大于利
弱(2)	利弊不确定或无论质量高低的证据均显示利弊相当

目标人群	应用场景	结果解读与临床意义
结核病疑似患者	结核病的辅助诊断	结核菌素皮肤试验阳性结果为活动性结核病尤其是病原学阴性结核病的诊断和鉴别诊断提供感染证据支撑
结核分枝杆菌潜伏感染高危人群(人类免疫缺陷病毒感染者、活动性肺结核患者的密切接触者、免疫抑制剂使用者等)	结核分枝杆菌潜伏感染诊断	在排除活动性结核病的前提下,结核菌素皮肤试验结果阳性提示检测对象处于结核分枝杆菌潜伏感染状态,可指导预防性治疗
结核病重点人群(学生、老年人、糖尿病患者等)	结核病和结核分枝杆菌潜伏感染者的主动发现	结核菌素皮肤试验可以与其他初筛工具并联或者串联使用,提高筛查覆盖率,在发现感染者的同时,为疑似患者的发现和转诊起到分流作用。同时,结核菌素皮肤试验的检测结果还可支撑重点人群中预防性治疗对象的主动发现