结核病宿主来源生物标志物的诊断应用专家共识

doi:10.19982/j.issn.1000-6621.20250426

摘要/Abstract

摘要：

结核病是严重威胁人类健康的重大传染病之一,尽管全球已在防控方面取得了一定进展,但其发病率和死亡率仍居高不下,我国防控形势依然严峻,对公共卫生构成巨大挑战。在结核病诊疗过程中,结核分枝杆菌潜伏感染(latent tuberculosis infection, LTBI)的发病风险评估、活动性结核病(active tuberculosis, ATB)的早期发现及抗结核治疗的监测等方面,仍是亟待解决的临床难点。生物标志物作为反映机体病理和免疫应答过程的客观指标,对优化诊断、指导个体化治疗至关重要。为此,中国防痨协会、广州国家实验室与江西省胸科医院联合组织国内相关领域专家,结合国内外最新进展及我国国情,制定《结核病宿主来源生物标志物诊断应用专家共识》。本共识重点聚焦于宿主来源的生物标志物,系统梳理了基于细胞免疫应答、宿主基因表达谱、细胞因子等在结核病诊疗中的应用现状与证据,并针对LTBI诊断与进展风险评估、ATB早期诊断与鉴别诊断、耐药结核病识别、治疗反应动态监测及复发风险预测等关键临床问题,基于循证医学的原则提出了具体的推荐意见和实用建议。本共识旨在为我国临床医师、检验人员和公共卫生人员在结核病生物标志物的科学选择、规范应用和准确解读方面提供指导,以期提升我国结核病诊疗防控水平。

关键词: 分枝杆菌, 结核, 感染, 生物学标记, 诊断, 鉴别, 总结性报告(主题)

Abstract:

Tuberculosis is a major infectious disease that seriously threatens human health. Although global progress has been made in its prevention and control, its morbidity and mortality rates remain high. The situation for tuberculosis control in China is particularly severe, posing a significant public health challenge. In the clinical management of tuberculosis, unresolved difficulties persist, including the risk assessment of progression from latent tuberculosis infection (LTBI), the early detection of active tuberculosis (ATB), and the monitoring of anti-tuberculosis therapy. As objective indicators reflecting the host’s pathological and immunological responses, biomarkers are crucial for optimizing diagnosis and guiding individualized therapy. To this end, the Chinese Antituberculosis Association, Guangzhou National Laboratory, and Jiangxi Chest Hospital jointly organized domestic experts in relevant fields, combined with the latest progress at home and abroad and China’s national conditions, to develop the Expert consensus on the application of host biomarkers for tuberculosis. This consensus focuses on host-derived biomarkers, systematically reviewing the current applications and evidence for those based on cell-mediated immune responses, host gene expression profiles, and cytokines in the management of tuberculosis. Furthermore, it addresses key clinical questions—including the diagnosis and progression risk assessment of LTBI, early and differential diagnosis of ATB, identification of drug-resistant tuberculosis, dynamic monitoring of treatment response, and prediction of relapse risk. Based on the principles of evidence-based medicine, the consensus puts forward specific recommendations and practical suggestions. It aims to provide guidance for clinicians, laboratory professionals, and public health practitioners in China on the scientific selection, standardized application, and accurate interpretation of tuberculosis biomarkers, with the goal of improving the level of tuberculosis prevention and control.

Key words: Mycobacterium tuberculosis, Infection, Biological markers, Diagnosis, differential, Consensus development conferences as topic

中图分类号:

江西省胸科医院/江西省卫生健康结核病重点实验室, 广州国家实验室, 中国防痨协会. 结核病宿主来源生物标志物的诊断应用专家共识[J]. 中国防痨杂志, 2026, 48(1): 9-20. doi: 10.19982/j.issn.1000-6621.20250426

Jiangxi Chest Hospital/Jiangxi Provincial Key Laboratory of Tuberculosis , Guangzhou National Laboratory , Chinese Antituberculosis Association . Expert consensus on the application of host biomarkers for tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(1): 9-20. doi: 10.19982/j.issn.1000-6621.20250426

图/表 2

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