Abstract
The assessment of screening of children and teenagers with application of the antigen tuberculosis recombinant (ATR) for the purpose of selection of persons with the changed sensitivity for carrying out the further inspection including the computer tomography of respiratory organs (CTRO) is carried out. Informational content of CT in group of therapeutic risk was analyzed. Introduction of tests with the ATR led to reduction of quantity to be surveyed at the phthisiatrician from 14,4% selected on the basis of data of a tuberculin test (TT), up to 2,6% by results of tests with the ATR in 2015, to decrease of number of the persons which are subject to preventive treatment of latent tuberculosis infection, reduction of observed children with postvaccination allergy, and also body height of number observed in IIIA dispensary registration group more than by 6 times. Application of the ATR was more informative among teenagers where the positive take of test about the ATR was followed by detection of local changes the CT method by 12,4 times more often than among children. Informational content of CT is higher than classical X-ray analysis of respiratory organs by 7,6 times and lack of this look in comprehensive examination of risk groups leads to a poor identification of tubercular changes in 47,4% of cases with the changed sensitivity on the ATR. Practically lack of signs of tubercular defeat on CTRO in group of therapeutic risk confirms specificity of test with the ATR in selection of risk group on a disease of tuberculosis. The absence of signs of tuberculosis lesion on a computer tomogram of the chest in the group of therapeutic risk confirms the specificity of the sample with the allergen tuberculosis recombinant for the selection of the risk group for tuberculosis.
Highlights
Проведена оценка скрининга детей и подростков с применением аллергена туберкулезного рекомбинантного с целью отбора лиц с измененной чувствительностью для проведения дальнейшего обследования, включающего компьютерную томографию органов дыхания
Introduction of tests with the antigen tuberculosis recombinant (ATR) led to reduction of quantity to be surveyed at the phthisiatrician from 14,4% selected on the basis of data of a tuberculin test (TT), up to 2,6% by results of tests with the ATR in 2015, to decrease of number of the persons which are subject to preventive treatment of latent tuberculosis infection, reduction of observed children with post-vaccination allergy, and body height of number observed in IIIA dispensary registration group more than by 6 times
Application of the ATR was more informative among teenagers where the positive take of test about the ATR was followed by detection of local changes the CT method by 12,4 times more often than among children
Summary
Отсутствие признаков туберкулезного поражения на компьютерной томограмме грудной клетки в группе терапевтического риска подтверждает специфичность пробы с аллергеном туберкулезным рекомбинантным для отбора группы риска по заболеванию туберкулезом. С введением кожно-аллергической пробы с аллергеном туберкулезным рекомбинантным в широкую практику обследования детей и подростков в соответствии с приказом МЗ РФ от 29.12.2014 No 951 [1] изменились показания к направлению в противотуберкулезное учреждение, а внедрение КТ органов грудной клетки обеспечило выполнение алгоритма диагностики туберкулеза в полном объеме [2]. Цель исследования: изучить эффективность комплексного обследования с применением кожного теста с аллергеном туберкулезным рекомбинантным и КТ органов грудной клетки у детей и подростков групп риска по туберкулезу, в рамках проведения скринингового обследования детей в возрасте 8–17 лет для диагностики туберкулезной инфекции. Оценить диагностическую значимость КТ органов грудной клетки в диагностике туберкулеза путем сравнения с рентгенологическими данными у детей с заболеваниями органов дыхания неспецифической этиологии
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