反对 anergy 测试作为结核素皮肤测试的常规辅助的情况
B S Slovis1, J D Plitman, D W Haas
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn, USA.
JAMA
|May 2, 2000
概括
无能测试不会改善对结核病查或诊断的阴性结核素皮肤测试的解释. 它的结果不能预测疾病的进展,这使得它在临床决策中不可靠.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 结核素皮肤检测 (TST) 是一种常见的查潜伏结核病感染和指导异化物预防的方法.
- 使用控制抗原的无能测试有时用于解释非反应性TST结果.
- 人们对能量测试协议和解释的标准化和有效性存在担忧.
研究的目的:
- 评估 anergy 测试在解释阴性结核素皮肤测试结果中的临床有用性和有效性.
- 为了确定是否有助于诊断结核病或预测疾病进展.
主要方法:
- 审查现有的文献和临床实践,关于nergy测试和结核素皮肤测试.
- 控制抗原活性对TST解释和临床决策的影响分析.
- 评估对艾滋病毒阴性和艾滋病毒阳性个体结核病进展的预测价值.
主要成果:
- 无能测试缺乏用于抗原选择,反应标准和解释的标准化协议.
- 控制抗原的反应性不会影响关于潜伏结核病感染或预防的决定.
- 无能测试结果不能预测任何患者群体的活跃结核病进展的风险.
- 负的TST结果,即使是对其他抗原的积极反应,也不排除潜伏或活跃的结核病.
结论:
- 无能测试不是用于查无症状结核病感染的有用工具.
- 无能测试不能帮助诊断活动性结核病.
- 当怀疑结核病感染时,微生物学评估仍然是必不可少的,无论TST或 anergy测试结果如何.
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