胸部X射线扫描在艾滋病毒感染者肺结核预防计划中的价值,博茨瓦纳
B Mosimaneotsile1, E A Talbot, T L Moeti
1BOTUSA Project, US Centers for Disease Control and Prevention, Gaborone, Botswana. baru1@cdc.gov
Lancet (London, England)
|November 15, 2003
概括
对于开始预防结核的无症状艾滋病毒感染者来说,常规的胸部X射线检查是不必要的. 查症状是足够的,因为胸部X射线在本研究中几乎没有结核病诊断.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 艾滋病毒/艾滋病管理
背景情况:
- 对于艾滋病毒感染者来说,建议预防结核病 (TB).
- 世界卫生组织 (WHO) /联合国艾滋病规划署 (UNAIDS) 的指导方针建议在开始预防结核病之前先做病史,症状查和胸部X射线扫描.
- 在这种特定情况下,常规胸部X射线扫描的实用性仍然不清楚.
研究的目的:
- 评估胸部X射线扫描在查无症状的艾滋病毒感染的门诊患者结核病的价值,在开始伊索尼亚齐德预防治疗之前.
主要方法:
- 一项前性研究涉及935名感染艾滋病毒的门诊患者,他们正在寻求异化的预防治疗.
- 患者接受了症状查.
- 进行了胸部放射,随后对结核病诊断进行了分析.
主要成果:
- 在935名患者中,692名 (74%) 没有结核病症状.
- 在无症状患者中,123人 (18%) 在X线图过程中失去了随访.
- 在剩余的563名无症状个体中,只有1名患者 (0.2%) 在胸部放射图的基础上被诊断为结核病.
结论:
- 对于无症状的艾滋病毒感染者,不建议在具有有效症状查的环境中开始使用异化预防治疗的例行胸部放射.
- 仅仅症状查似乎就足以在这个人群中识别活跃的结核病.
- 这种方法可以简化结核病预防的启动,减少医疗保健资源的利用.
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