华西医学

华西医学

经验医学向精准医学的转变——《肺结核诊断》(WS 288-2017)解读

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对《肺结核诊断》(WS 288-2017)从医学模式变迁的角度,就肺结核分类、诊断标准、诊断内容 3 个方面进行解读,指出肺结核分类中新增加气管支气管结核和结核性胸膜炎,诊断标准强调了结核分子生物学和病理学检查结果的诊断价值,并在内容中新增了耐药状况。最后从可行性和发展趋势方面提出 2 点建议:基层地区仍可考虑保留诊断性治疗等实用技术作为诊断依据,有条件的单位则需开拓新的分子技术增加结核杆菌 DNA/RNA 鉴定、耐药基因检测以利精准诊断。

Basing on development of medical model, new national diagnostic standard is interpreted according to three aspects: classification, diagnostic standard, and diagnostic contents. Tracheobronchial tuberculosis and tuberculous pleurisy are added into the classification. The value of molecular and pathological techniques for diagnosis of the pulmonary tuberculosis is emphasized. The status of drug-resistance is included in the diagnostic content. Two opinions are suggested: some practical methods such as diagnostic chemotherapy are indicated in some grassroots areas, while new molecular techniques for detection of DNA/RNA of mycobacteria and resistant mutation are encouraged in some suitable institutions.

关键词: 肺结核; 诊断标准; 精准医学

Key words: Pulmonary tuberculosis; Diagnostic standard; Precision medicine

引用本文: 陈雪融, 陈效友. 经验医学向精准医学的转变——《肺结核诊断》(WS 288-2017)解读. 华西医学, 2018, 33(8): 950-952. doi: 10.7507/1002-0179.201807076