ObjectiveTo investigate the relationship between the mannose-binding lectin 2 (MBL2) codon 52 A/D gene polymorphism and tuberculosis risk by meta-analysis. MethodsThe Embase, PubMed, China National Knowledg Infrastructure, Wanfang databases were searched to identify domestic and foreign case-control studies involving the association between MBL2 codon 52 A/D gene polymorphism and tuberculosis risk from establishment of these database till May 20, 2015. Two reviewers collected data according to the inclusion and exclusion criteria, and extracted data and assessed quality of the literature. Meta analysis was performed by RevMan 5.2 software and Stata 10.0 software. ResultsIn total, 1 282 cases and 1 483 controls from nine case-control studies were included in this meta-analysis. According to the test of heterogeneity, there was statistical heterogeneity among these studies (P < 0.1). Thus, we conducted the analysis by the random effect model on the basis of heterogeneity test. The results indicated that MBL2 codon 52 A/D gene polymorphism might not be associated with risk of tuberculosis [DD+AD versus AA: OR=1.46, 95% CI (0.87, 2.43), P=0.15] in total analysis by random effect model. However, when stratifying separately according to ethnicity, a significant association between MBL2 codon 52 A/D gene polymorphism and tuberculosis risk was found in Asians [OR=1.96, 95% CI (1.27, 3.03), P=0.003 for DD+AD versus AA], but not among Caucasians [OR=1.36, 95% CI (0.52, 3.56), P=0.53 for DD+AD versus AA]. Conclusions The present meta-analysis indicates that the polymorphism of MBL2 codon 52 A/D may be a risk factor for TB in Asians. But the MBL2 codon 52 A/D gene polymorphism may not contribute to the risk of tuberculosis in Caucasians.
Objective To systematically review the treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) patients, and to provide evidence for treatment. Methods Databases including PubMed, Web of Science, ScienceDirect, CNKI, WanFang Data and VIP were electronically searched to collect literature related to MDR-TB from inception to April 28th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using R 4.0.5 software, subgroup and meta-regression analyses were performed based on sample size, survey time, etc. Results A total of 36 studies involving 7 981 patients were included. The results of meta-analysis showed that the overall treatment success rate of MDR-TB patients was 60% (95%CI 56% to 63%). The subgroup analysis showed that the treatment success rates of MDR-TB were 49% (95%CI 41% to 58%) from 1992 to 2010, 62% (95%CI 58% to 65%) from 2011 to 2015, and 62% (95%CI 55% to 68%) from 2016 to 2020; those with sample size above 100 and less than 100 were 60% (95%CI 55% to 65%) and 59% (95%CI 54% to 63%), respectively; those with average age above 45 and less than 45 were 58% (95%CI 51% to 65%) and 56% (95%CI 53% to 59%); those of MDR-TB were 63% (95%CI 57% to 68%) in central China, 63% (95%CI 52% to 73%) in the Northwest, 60% (95%CI 55% to 65%) in the Southeast, and 53% (95%CI 48% to 58%) in the Northeast. Conclusions The overall success rate of treatment for MDR-TB patients in China is low. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify the above conclusions.
目的:探讨临床一线抗结核药物引起肝损害状况及预后,以提高对结核化疗致药物性肝炎的认识。方法:采用回顾性对比分析短程间歇化疗方案(2H3R3Z3E3/4H3R3)与短程每日化疗方案(2HRES/7HRE)之间抗结核治疗后对肝功能损害的发生率。结果:1144例中,发生药物性肝损害157例,其中间歇化疗方案发生药物性肝损害118例,占75.2%,每日化疗方案发生药物性肝损害39例,占24.8%。同时还发现体质状况差、病情重、老年人及有慢性酗酒者结核药物性肝损害发生率高。结论:药物性肝炎是影响结核病化疗的重要因素。短程间歇化疗方案治疗应因人而异,不宜广泛用于老年人、体质状况差、病情重、有慢性酗酒者的结核病患者。
目的:探讨糖尿病合并结核病的临床特征、诊断和治疗。方法:分析总结了49例老年糖尿病合并结核病患者的临床资料,同时与老年单纯肺结核患者进行了对比。结果:两组临床症状无显著性差异,糖尿病合并肺结核组干酪渗出性病灶要多于单纯肺结核组(Plt;0.05),中、下叶病灶要多于单纯肺结核组(Plt;0.01)。两组疗效无显著性差异(Pgt;0.05)。 结论: 糖尿病合并结核病应引起高度重视,正确诊断和及时处理是提高疗效重要手段。
Objective To investigate the clinical application value of GeneXpert Mycobacterium tuberculosis (MTB)/ rifampin (RIF) in urine samples for tuberculosis diagnosis. Methods The patients with clinically highly suspected tuberculosis admitted to West China Hospital of Sichuan University between January 1, 2018 and June 1, 2023 were selected retrospectively. The diagnostic efficacy of urine GeneXpert MTB/RIF detection, such as sensitivity, specificity, positive predictive value, and negative predictive value, were retrospectively analyzed to evaluate its clinical value in the diagnosis of tuberculosis. Correlation analysis was further conducted to explore the correlation between positive levels of GeneXpert MTB/RIF in urine samples and laboratory test indicators. Results A total of 400 patients were included. Among them, 163 cases were in the clinical tuberculosis group and 237 cases were in the clinical non tuberculosis group. In the clinical tuberculosis group, 112 cases were urogenital tuberculosis patients and 51 cases were non-urogenital tuberculosis patients. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of tuberculosis were 55.2%, 97.5%, 93.8% and 76.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of urogenital tuberculosis were 65.2%, 92.0%, 76.0% and 87.2%, respectively, and the diagnostic sensitivity was further improved. Correlation analysis showed that the positive degree of urine GeneXpert MTB/RIF was correlated with the levels of hemoglobin, serum total protein, blood serum albumin, and other indicators. Conclusions Urine GeneXpert MTB/RIF detection offers high sensitivity and specificity in the diagnosis of tuberculosis, especially in urogenital tuberculosis, which is helpful for the early and rapid diagnosis of tuberculosis patients. The positive degree reported by the GeneXpert MTB/RIF in urine may indicate disease severity.
2010 年世界卫生组织( WHO) 年度报告指出, 中国2009 年有110 万至150 万名结核患者, 并且每 10 万人口中即有新增病例50 至99 人。报告中也提到, 近年吸毒人数增多, 世界范围内有11% ～ 13% 的结核患者呈HIV 阳性。而在中国, 虽然仅有 1. 5% 的新增结核患者显示HIV 阳性, 比2007 年的 1. 9% 略有下降, 但中国结核病群体巨大, 其形势仍不容忽视[ 1, 2 ] 。
目的:比较4种选药方案治疗复治后耐多药结核病的治疗疗效。方法:回顾性分析152例复治后耐多药结核病例,按治疗方案分为4组。Ⅰ组采用标准化疗方案HSRZE;Ⅱ组根据过去的治疗史组成个体化方案;Ⅲ组根据药敏试验组成个体化方案;Ⅳ组采用力克肺疾、左氧氟沙星、卷曲霉素、阿奇霉素、阿莫西林克拉维酸方案。结果:4组病灶吸收有效率分别为20.00%、47.37%、52.38%、81.48%;4组12个月疾菌阴转率分别为22.22%、57.89%、50.00%、81.48%。结论:对于所有复治肺结核患者均采用统一的标准复治方案有效率低,由力克肺疾、左氧氟沙星、卷曲霉素、阿奇霉素、阿莫西林克拉维酸联合组成的化疗方案是治疗复治后耐多药结核病的有效方案。
Chest wall tuberculosis is a common extra-pulmonary tuberculosis, which often occurs in lung or pleura tuberculosis, or coexists with tuberculosis in other parts. The final manifestation of the disease is cold abscess on the chest wall, chronic sinuses with repeated exudation after the abscess is broken. At present, There were a series of problems in the diagnosis, treatment, and extremely prognosis of tuberculosis of the chest wall. Therefore, we reviewed the diagnosis of chest wall tuberculosis, including B-ultrasound, chest CT and positron emission tomography/computed tomography (PET/CT), tuberculous infectin of T cells spot test (T-SPOT TB), pathological examination. The related treatments including medical treatment, surgical treatment and other local treatment in order to better understand the chest wall tuberculosis.
ObjectiveTo evaluate the diagnostic value of interferon-gamma release assay (TB-IGRA) for tuberculosis in the Tibetan. MethodsFrom January 2014 to December 2014, suspected Tibetan tuberculosis patients were enrolled from AVIC 363 Hospital and underwent TB-IGRA test. All patients were also underwent smear test for Mycobacteria. The diagnostic value of TB-IGRA test for Tibetan TB patients was analyzed. ResultsA total of 77 suspected Tibetan tuberculosis patients were included. According to the diagnostic criteria, of the 77 suspected patients, 50 were diagnosed as TB patients, and 27 were diagnosed as not-TB patients. The sensitivity and specificity of TB-IGRA test was 86% and 81.5%. While the sensitivity and specificity of smear test were 22% and 100%, respectively. ConclusionThe TB-IGRA test is superior to smear test, and is the fast and sensitivity test for diagnosing Tibetan TB patients.