결핵반응검사 결과 - gyeolhaegban-eung-geomsa gyeolgwa

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선별검사이며 활동성 결핵 진단은 불가능

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방법 ) 소량(0.1mL)의 PPD를 전막 내측에 바늘은 5~15도 각도로 사면이 위로 가도록 한 뒤 피내주사

6~10mm의 팽진이 생기도록 한다. → 48~72 시간 내 경결 부위 크기를 확인한다.

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*주사부위는 누르거나 문지르지 않는다.

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해석 ) 경결의 크기로 판독

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1. 음성 4mm 이하 경결

: 결핵균에 세포성 매개면역이 없어 결핵균 노출로 감염될 우려가 있음

: BCG 접종 대상자

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2. 의양성 5-9mm 경결

: 면역체계가 손상된 경우 양성으로 본다. (HIV 환자)

: 재검사 하거나 반대쪽에 동량의 생리식염수를 피내 주사하여 결과를 비교한다.

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3. 양성 10mm 경결

: 한번 양성으로 반응하면 계속해서 양성으로 반응한다.

: 과거나 현재에 결핵균의 감염으로 인해 결핵균에 노출되어있음을 의미한다.

: BCG(결핵생균) 예방접종 후

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+ 일시적 음성

: 생백신 접종 후 4주 이상 경과되지 않은 경우

: 홍역, 볼거리, 수두, 인플루엔자 같은 바이러스 감염

: 아주 심한 결핵 (속립성 결핵,다른 부위의 중증 결핵)

: 결핵 감염 초기 (노출 후 4~6주 뒤에 양성으로 나옴)

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투베르쿨린 반응 저하 요인)

: 피하주입, 영양부족, 면역결핍, 코티코스테로이드, 항결핵제 복용

미국으로 가는 유학생들은 결핵감염 여부를 확인하는 피부반응검사인 투베르쿨린 검사(Tuberculin skin test, TST, Mantoux test)결과를 꼭 제출해야 한다.  학교에 따라서는 고가의 인터페론감마 분비검사(interferon-γ releasing assay, IGRA, QuantiFERON®)를 요구하기도 한다.

투베르쿨린 검사에 대해 알아본다.

결핵균이 몸에 들어오면2~8주내에 면역반응이 형성되어 적절한 치료가 끝난 후에도 대부분 평생 지속된다. 이렇게 형성된 면역반응을 투베르쿨린 검사로 확인할 수 있다.  PPD라고 부르는 결핵균 항원을 피부에 주사하여 2~3일 후 양성반응을 보이면 결핵균이 몸 속에 들어왔음을 의미한다.  그러나 지난 포스트 내용처럼 잠복결핵 감염자, 결핵이 완치된 사람 등등도 양성반응을 보이므로 성인에서는 결핵진단 목적으로는 사용되지 않고 단지 잠복결핵 진단 도구로 유용하다. 

현재 참고 페이지

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