儿童结核病的诊治进展

潘家华, 张雪

中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (2) : 218-224.

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中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (2) : 218-224. DOI: 10.7499/j.issn.1008-8830.2014.02.027
综述

儿童结核病的诊治进展

  • 潘家华, 张雪
作者信息 +

Recent advances in the diagnosis and treatment of childhood tuberculosis

  • PAN Jia-Hua, ZHANG Xue
Author information +
文章历史 +

摘要

结核病是一种严重危害人类健康的慢性传染性疾病,临床表现不典型,尚缺乏灵敏度较高的有效检查手段,临床诊断难度较大。由于多重耐药性结核菌株(MDR-TB)的产生及儿童用药的局限性,以致儿童结核病的治疗愈加困难。该文就儿童结核杆菌感染的流行病学史、临床表现、结核菌素皮肤试验、影像学检查、实验室检查等与结核病诊断有关的研究进展以及治疗措施在近些年的发展做一综述。

Abstract

Tuberculosis (TB) is a chronic infectious disease that seriously harms human health and wellbeing. Given its atypical clinical manifestations, TB is hard to be diagnosed in clinical settings; to date no highly sensitive screening approaches are available. Due to the emergence of multidrug-resistant strains of TB (MDR-TB) and limited options for medications in children, the treatment of TB is even more challenging in pediatric patients. This paper aims to comprehensively review the literature on the recent advances in the research on the epidemiology and clinical manifestations of TB, on TB diagnostic approaches (e.g., tuberculin skin test, imaging studies, and laboratory tests), and on TB treatment in children.

关键词

结核病 / 诊断 / 治疗 / 儿童

Key words

Tuberculosis / Diagnosis / Treatment / Child

引用本文

导出引用
潘家华, 张雪. 儿童结核病的诊治进展[J]. 中国当代儿科杂志. 2014, 16(2): 218-224 https://doi.org/10.7499/j.issn.1008-8830.2014.02.027
PAN Jia-Hua, ZHANG Xue. Recent advances in the diagnosis and treatment of childhood tuberculosis[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(2): 218-224 https://doi.org/10.7499/j.issn.1008-8830.2014.02.027

参考文献

[1] Chung HS, Lee JH. Bronchoscopic assessment of the evolution of endobronchial tuberculosis[J]. Chest, 2000, 117(2): 385-392.
[2] Perez-Velez CM, Marais BJ. Tuberculosis in children[J]. N Engl J Med, 2012, 367(4): 348-361.
[3] Sohn H, Minion J, Albert H, et al. TB diagnostic tests: how do we figure out their cost?[J]. Expert Rev Anti Infect Ther, 2009, 7(6): 723-733.
[4] Monteiro R, Carvalho A, Duarte R. New opportunities in tuberculosis control[J]. Eur Respir J, 2012, 39(5): 1271-1273.
[5] Duarte R, Neto M, Carvalho A, et al. Improving tuberculosis contact tracing: the role of evaluations in the home and workplace[J]. Int J Tuberc Lung Dis, 2012, 16(1): 55-59.
[6] 张红岩, 唐风霞, 张春雨. 儿童结核病全程督导短程化疗及 免疫治疗观察[J]. 河北医药, 2010, 32(8): 970-971.
[7] Wood R, Johnstone-Robertson S, Uys P, et al. Tuberculosis transmission to young children in a South African community: modeling household and community infection risks[J]. Clin Infect Dis, 2010, 51(4): 401-408.
[8] Moyo S, Verver S, Mahomed H, et al. Age-related tuberculosis incidence and severity in children under 5 years of age in Cape Town, South Africa[J]. Int J Tuberc Lung Dis, 2010, 14(2): 149-154.
[9] Lalvani A, Pareek M. Interferon gamma release assays: principles and practice[J]. Enferm Infecc Microbiol Clin, 2010, 28(4): 245-252.
[10] Chiappini E, Accetta G, Bonsignori F, et al. Interferon-γrelease assays for the diagnosis of Mycobacterium Tuberculosis infection in children:A literature review[J]. Int J Immunopathol Pharmacol, 2012, 25(3): 557-564.
[11] Bendayan D, Hendler A, Litman K, et al. The role of interferongamma release assays in the diagnosis of active tuberculosis[J]. Isr Med Assoc J, 2012, 14(2): 107-110.
[12] National Institute for Health and Clinical Excellence. Clinical Guideline 33, Tuberculosis: clinical diagnosis and management of tuberculosis and measurement for its prevention and control
[S/OL]. NICE, London, UK, 2006[December 1, 2007]. http://www. nice.org.uk.
[13] Ben Selma W, Harizi H, Marzouk M, et al. Rapid detection of immunoglobulin G against Mycobacterium tuberculosis antigens by two commercial ELISA kits[J]. Int J Tuberc Lung Dis, 2010, 14(7): 841-846.
[14] Bocchino M, Bellofiore B, Matarese A, et al. IFN-γrelease assays in tuberculosis management in selected high-risk populations[J]. Expert Rev Mol Diagn, 2009, 9(2): 165-177.
[15] 胡杰英, 陈冬花, 刘书磊. 红细胞沉降率、抗结核抗体及结 核菌素试验在肺结核诊断中的价值[J]. 现代医药卫生, 2012,[16] Nemeth J, Winkler HM, Zwick RH, et al. Peripheral T cell cytokine responses for diagnosis of active tuberculosis[J]. PLoS One, 2012, 7(4): e35290.
[17] Steingart KR, Henry M, Ng V, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis:a systematic review[J]. Lancet Infect Dis, 2006, 6(9): 570-581.
[18] Connell TG, Zar HJ, Nicol MP. Advances in the diagnosis of pulmonary TB in HIV-infected and HIV-uninfected children[J]. J Infect Dis, 2011, 204 (Suppl 4): S1151-S1158.
[19] Hatherill M, Hawkridge T, Zar HJ, et al. Induced sputum or gastric lavage for community-based diagnosis of childhood pulmonary TB?[J]. Arch Dis Child, 2009, 94(3): 195-201.
[20] Nicol MP, Workman L, Isaacs W, et al. Accuracy of the Xpert MTB/RIF test for the diagnosis of pulmonary TB in hospitalized children in Cape Town, south Africa: a descriptive study[J]. Lancet Infect Dis, 2011, 11(11): 819-824.
[21] 张廷梅, 李杭, 袁国琴, 等. 支气管镜在儿童支气管结核诊 断治疗中应用价值[J]. 临床荟萃, 2011, 26(15): 1340-1342.
[22] Fang R, Li X, Hu L, et al. Cross priming amplification for rapid detection of Mycobacterium tuberculosis in sputum specimens[J].J Clin Microiol, 2009, 47(3): 845-847.
[23] Blakemore R, Story E, Helb D, et al. Evaluation of the analytical performance of the Xpert MTB/RIF assay[J].J Clin Microbiol, 2010, 48(7): 2495-2501.
[24] Marais BJ. Tuberculosis in children[J]. Pediatr Puhnonol, 2008, 43(4): 322-329.
[25] 胡智贤. 抗结核加免疫调节剂治疗难治性肺结核49 例[J]. 河 南科技大学学报(医学版), 2009, 27(2): 95-97.
[26] Almeida LP, Trombone AP, Lorenzi JC, et al. B cells can modulate the CD8 memory T cell after DNA vaccination against experimental tuberculosis[J]. Genet Vaccines Ther, 2011, 9(1): 5.
[27] Sadeghi-SM, Vesal S, Jabbarpour-BM, et al. Novel RAG2 mutation in a patient with T-B-severe combined immunodeficiency and disseminated BCG disease[J]. J Investig Allergol Clin Immunol, 2009, 19(6): 494-496.
[28] Sosnik A, Seremeta KP, Imperiale JC, et al. Novel formulation and drug delivery strategies for the treatment of pediatric povertyrelated diseases[J]. Expert Opin Drug Deliv, 2012, 9(3): 303-323.
[29] Saidemberg DM, Passarelli AW, Rodrigues AV, et al. Shikimate kinase (EC 2.7.1.71) from Mycobacterium tuberculosis: kinetics and structural dynamics of a potential molecular target for drug development[J]. Curr Med Chem, 2011, 18(9): 1299-1310. 28(8): 1144-1146.

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