吸入用コルチコステロイドを使用する呼吸器阻害疾患患者の結核に対するシステマティックスクリーニングの効果
Manju Rajaram1, Palanivel Chinnakali2, Vinayagamoorthy Venugopal3
1Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Lung India : official organ of Indian Chest Society
|September 2, 2025
まとめ
高用量の吸入用コルチコステロイドを使用する患者および糖尿病患者は結核のリスクが高くなります. 早期に結核を検出するために,これらの個人に標的型スクリーニングが推奨されます.
科学分野:
- 肺医学
- 感染症
- 薬理学について
背景:
- 吸入用コルチコステロイド (ICS) は結核 (TB) のリスクの増加と関連しています.
- ICS使用者における結核発症の特定の危険因子については,さらなる調査が必要である.
研究 の 目的:
- 呼吸用コルチコステロイドを使用する患者の結核の危険因子を特定する.
- この集団における結核の標的型スクリーニング戦略の情報提供
主な方法:
- インドのプドゥチェリーで実施された横断的な研究.
- 1年以上のICS治療を受けた患者1550人を含め,結核の症状が推定された.
- 診断方法は,唾液のスプレー,胸部X線写真,CBNAAT,ブロンコスコーピー,および微生物学的確認のためのBALでした.
主要な成果:
- 糖尿病と高用量のICSは結核の独立リスク因子であった (OR:それぞれ6. 4と7).
- 他の危険因子には 男性の性別,冠動脈疾患,喫煙,アルコールの使用が含まれています.
- 結核の1例を特定するために262人の患者のスクリーニングが必要でした.
結論:
- 糖尿病患者および高用量ICSを受けている患者は,標的型結核スクリーニングを必要とします.
- 検診による早期発見は 脆弱な集団の結核管理に不可欠です
関連する概念動画
COPD: Management Using Bronchodilators and Corticosteroids
305
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
305
Pulmonary Tuberculosis IV
202
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
202
Pulmonary Tuberculosis V
237
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
237
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
383
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
383
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.6K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.6K
Asthma-IV: Diagnostic and Management
2.6K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.6K


