警惕儿童结缔组织疾病合并结核感染

摘要

结缔组织病患儿本身存在多种免疫紊乱,大剂量皮质激素、免疫抑制剂的应用加重了细胞免疫缺陷,生物制剂进一步增加了结核感染的风险.结缔组织病合并结核感染临床表现复杂,有时很难鉴别是原发疾病活动还足结核感染.肺部影像学检查是临床诊断结核病的主要手段,QFT-G试验和T-SPOT.TB开辟了辅助诊断新途径.应详细询问结核接触史、卡介苗接种史,常规进行血清结核杆菌抗体检测及PPD皮试.临床高度提示结核感染者,应给予诊断性抗结核治疗.%There are many immune disorders in children with connective tissue diseases. The use of high dose of steroid and immunosuppressant would aggravate cellular immunity defects. Biological agents would further increase the risk of tuberculosis infection. The clinical manifestations are very complex in children with connective tissue diseases combined tuberculosis infection. It is difficult to distinguish between connective tissue disease activity and tuberculosis infection. Lung imaging is the primary means of diagnose of tuberculosis infection. Quanti FERON-TB Gold test and TSPOT.TB test had been developed to assist diagnosis. For children with connective tissue diseases, TB contact history and BCG vaccination history should be inquired, and serum TB antibody and PPD skin test should be performed. Diagnostic treatment should be conducted when tuberculosis infection is highly suspected.