结核病

什么是结核病?

Tuberculosis, or TB, is a bacterial infection that usually infects the lungs. Other organs, such as the kidneys, spine, or brain may also be involved. TB is primarily spread from person to person in an airborne manner, 比如当感染者咳嗽或打喷嚏时. It can also cause an active infection after a period of not being active in someone who was exposed at an earlier time.

There is a difference between being infected with the TB bacterium and having active tuberculosis disease.

以下是结核病的阶段:

1. 曝光. This happens when a person has been in contact with, or exposed to, another person who has TB. 接触者皮肤试验呈阴性, 正常的胸片, 没有任何疾病的迹象或症状.
2. 潜伏性结核感染. This happens when a person has TB bacteria in his or her body, 但没有这种疾病的症状. The infected person's immune system walls off the TB organisms, and the TB remains inactive throughout life in most people who are infected. This person would have a positive skin test, but 正常的胸片.
3. 结核病. This describes the person who has signs and symptoms of an active infection. The person would have a positive skin test and a positive chest X-ray.

结核病的病因?

结核病的主要细菌是结核分枝杆菌. 结核). Many people infected with this bacterium never develop active TB. 它们仍处于潜伏(不活跃)结核阶段. 然而, 免疫系统较弱的人, 特别是艾滋病毒(人类免疫缺陷病毒)感染者, or those receiving medicines that suppress the immune system, 结核菌可以克服人体的防御, 乘, 导致活动性疾病.

The TB bacterium is spread through the air when an infected person coughs, 打喷嚏, 说话, 唱, 或笑. 它不太可能通过个人物品传播, 比如服装, 床上用品, 一个水杯, 餐具, 握手, 一个厕所, 或结核病患者接触过的其他物品. Good ventilation is the most important measure to prevent the transmission of TB.

谁有患结核病的风险?

结核病影响所有年龄、种族和收入水平的人. 风险较高的人群包括:

• 与结核病患者一起生活或工作的人
• 那些无法获得医疗保健的人
• 无家可归的人
• 来自结核病流行的其他国家的人
• 在集体环境中的人，比如养老院
• 滥用酒精的人
• 静脉注射毒品的人
• 免疫系统弱的人
• 老年人
• 健康care workers who come in contact with high-risk populations

结核病的症状是什么?

以下是活动性结核病最常见的症状. 然而, each person may experience symptoms differently:

• 咳嗽持续3周或更长时间
• 胸部疼痛
• 乏力
• 食欲不振
• 意外减肥
• 儿童发育不良
• 发热
• 咳血或痰
• 发冷或盗汗

The symptoms of TB may look like other lung conditions or medical problems. 向医疗保健提供者咨询诊断.

如何诊断结核病?

结核病通常通过皮肤试验诊断. In this test, a small amount of testing material is injected into the top layer of the skin. 如果在2 - 3天内出现一定大小的肿块, 结核菌感染试验可能呈阳性. 其他检查包括x光检查和痰液检查. 血液测试可以代替结核菌皮肤测试.

建议对以下人员进行结核菌皮肤试验:

• 高风险类别
• Who live or work in close contact with people who are at high risk
• 谁从未做过结核病皮肤试验

For skin testing in children, the American Academy of Pediatrics recommends testing:

• If the child is thought to have been exposed in the last 5 years
• 如果孩子的x光片看起来像结核病
• 如果孩子有任何结核病症状
• 如果孩子来自结核病流行的国家
• 为感染艾滋病毒的儿童
• For children receiving medicines that suppress the immune system
• 给那些被关在拘留所的孩子
• 对于接触高危人群的儿童
• 如果孩子的父母来自高风险国家
• 如果孩子去过高危地区
• 如果孩子生活在人口稠密的地区

如何治疗结核病?

Your healthcare provider will figure out the best treatment for you based on:

• 你多大了?
• 你的整体健康状况和过去的健康状况
• 你病得有多严重?
• How well you can handle specific medicines, procedures, or therapies
• 这种情况预计会持续多久
• 你的意见或偏好

治疗包括:

• 短期住院治疗
• For latent TB which is newly diagnosed: Usually a 6 to 12 month course of antibiotic called isoniazid will be given to kill off the TB organisms in the body. Some people with latent TB may be treated with a shorter course of 2 antibiotics for only 3 months.
• For active TB: Your healthcare provider may prescribe 3 or more antibiotics in combination for 6 to 9 months or longer. Examples include: isoniazid, rifampin, pyrazinamide, and ethambutol. People usually begin to improve within a few weeks of the start of treatment. After several weeks of treatment with the correct medicines, 患者通常不再具有传染性, 如果治疗进行到最后, 由医疗保健提供者开具处方.

结核病的并发症有哪些?

If TB is not treated early or if treatment isn’t followed, permanent lung damage can result.

结核病可以预防吗??

If you will be spending time with a person or people with active TB, wear a face mask and try not to stay in a small enclosed space with poor ventilation. People who work in situations where there is a high risk for encountering people infected with TB, 比如医护人员, 是否应该进行常规结核病检测. 在美国以外的国家.S. where TB is more common, a childhood vaccine is often given.

我应该什么时候给我的医疗保健提供者打电话?

If your symptoms get worse or you get new symptoms, let your healthcare provider know.

结核病防治要点

• Tuberculosis is a bacterial infection that usually infects the lungs.
• 它也可能影响肾脏、脊柱和大脑.
• Being infected with the TB bacterium is not the same as having active tuberculosis disease.
• There are 3 stages of TB—exposure, latent, and active disease.
• A TB skin test or a TB blood test can diagnose the disease.
• Treatment exactly as recommended is necessary to cure the disease and prevent its spread to other people.

下一个步骤

• Know the reason for your visit and what you want to happen.
• 在拜访之前，写下你想要回答的问题.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. 还要知道副作用是什么.
• 询问你的病情是否可以用其他方法治疗.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.