结核菌素皮肤试验阳性人群是否应该接受化学预防治疗

结核病是我国常见的呼吸道传染病之一,发病率和死亡率仍居传染病之首。WHO估计全球有1/3的人口感染结核分枝杆菌(MTB),即潜伏结核感染者(LTBI),而我国是结核病高负担国家之一,大约有40%⁴5%的人口感染MTB。LTBI者在2年内发展成为有临床表现的活动性结核病的风险为5%45%的人口感染MTB。LTBI者在2年内发展成为有临床表现的活动性结核病的风险为5%¹0%,如果采取化学预防,可以降低LTBI者2年内的发病率。LTBI的检测最常用的方法是结核菌素皮肤试验(TST),但并非所用TST阳性人群均适宜化学预防。在我国对于TST强阳性人群,尤其是结核病的高危人群,适合采取化学预防治疗。预防方案可以是单药异烟肼,也可以是异烟肼联合利福平或利福喷汀预防治疗,疗程及给药方式没有统一标准。

Whether the population with positive tuberculin skin test should accept chemoprophylaxis

Tuberculosis （TB） is one of the common respiratory infectious disease, it＆#39;s morbidity and mortality rate is on the top in contagious disease. WHO estimates that one third population were infected bymycobacterium tuberculosis （MTB）, namely latent tuberculosis infection （LTBI）. Our country is one of high burden of TB. Approx 40%-45% of population were infected MTB. LTBI population with 5%-10% risk will develop active TB in two years. If the LTBI population were given chemoprophylaxis, the incidence rate will be cut down in two years. The common assay method to LTBI is tuberculosis skin test （TST）. But not all of population with positive TST is received chemoprophylaxis. The population with strongly positive TST, especially have high risk to TB should accept chemoprophylaxis. The chemoprophylaxis regimens is single isoniazid, or isoniazid plus rifampicin or rifapentine. The course of therapy and administration have not criterion.