结核病总论英文.pptVIP

* * * * * * 我国结核病的疫情状况 WHO 93年宣布“全球结核病紧急状态”，98年又重申遏制结核病的行动刻不容缓。 全球现有结核病人2000万，其中95％在发展中国家，每年还会新发生800-1000万肺结核病，其中75％的病人年龄在15－50岁。如不控制，今后10年还将有9000万人发病。 中国是全球22个结核病高负担国家之一，结核病人数位居世界第二位，仅次于印度. 据调查全国三分之一的人口已感染了结核菌；受感染人数超过4亿,受结核感染人群中有10％的人发生结核病 * tuberculosis factor of tuberculosis incidence rising ： HIV spread. TB strain occur drug resistance . fluid population increasing. Management TB patient not perfect、prevention and cure not efficiency. Poverty、population increasing. * etiology Mycobacterium 、 Acid fastness、G+、aerobe。 Growth torpidity , culture need 4-6 weeks. Typing : human type 、 bovine type 、 Bird type、mouse type 、 main human type。 way of infection：respiration tract、digestive track、skin or placenta. * Epidemiology 1 infection sources：open pulmonary tuberculosis 2 route of transmission: by respiration way or digestion tract. 3 susceptible population * Epidemiology The factors lead Children ill with TB Contact TB amounts and toxicity. power of resistance . hereditary factor . * pathogenesy bacterial number、toxicity、immunization condition Cell-mediated immune reaction:macrophage swallow TB→antigen presentation Th and macrophage→IL12→CD+4→TH1-IF-γ→to promote mononuclear cell; to gather、activation、proliferation and differentiation→to produce alexin and oxidase 、 digestive enzyme→to kill TB * pathogenesy IF-reinforcement CD+8 、NK cells activity to phagocytosis TB. meanwhile to lead histoclasia delayed allergy : T cell media，macrophage to be effector cell，to kill reinfection TB and cause cheesy necrosis or hole formation After Infection TB : primary disease（5%），Secondary disease （5%）, not to fall ill all live(90%) * diagnose Objective to discover focal 。 Definite disease character、size whether or not deliver bacterium。 * diagnose 1 history TB toxic symptom to contact TB patient BCG vaccination acute infection:measles，pertussis Supersensitivity erythema nodosum、exanthematous conjunctivitis。 * diagnose 2 ：OT test agent：1/2000 or 1/10000 PPD dose：0.