《WHO结核病整合指南模块1：预防——结核病预防性治疗（第二版）》解读

doi:10.19871/j.cnki.xfcrbzz.2025.03.016

新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (3): 92-98.doi: 10.19871/j.cnki.xfcrbzz.2025.03.016

《WHO结核病整合指南模块1：预防——结核病预防性治疗（第二版）》解读

黄嘉敏, 柯学, 李国保, 卢水华

深圳市第三人民医院/国家感染性疾病临床医学研究中心肺病三科,广东深圳 518112

收稿日期:2025-04-10 出版日期:2025-06-30 发布日期:2025-07-24
通讯作者: 卢水华,Email：lushuihua66@126.com;李国保,Email：L3gb@qq.com
基金资助:
1.国家自然科学基金（32394014）;2.深圳市医学研究专项资金项目（C2405002）;3.深圳市科技计划项目基础研究（面上项目）（JCYJ20220530163212027）;4.深圳市高水平医院建设专项经费资助（25270G1032）

Interpretation of WHO consolidated guidelines on tuberculosis Module 1: prevention-tuberculosis preventive treatment, second edition

Huang Jiamin, Ke Xue, Li Guobao, Lu Shuihua

The Third Department of Pulmonary Diseases, Shenzhen Third People's Hospital, National Clinical Medical Research Center for Infectious Diseases, Guangdong Shenzhen 518112, China

Received:2025-04-10 Online:2025-06-30 Published:2025-07-24

摘要/Abstract

摘要： 结核分枝杆菌感染（tuberculosis infection,TBI）是指机体感染结核分枝杆菌（Mycobacterium tuberculosis,MTB）后对其抗原刺激产生持续性免疫应答,但没有结核病临床征象的一种状态。针对结核病高危人群进行结核病预防性治疗（tuberculosis preventive treatment,TPT）可以有效降低结核病发病率,是实现终结结核病战略全球目标的关键措施。自2020版《WHO结核病整合指南模块1：预防--结核病预防性治疗》发布以来,多项新进展推动了TPT政策的更新,主要包括WHO结核病筛查指南和TBI检测指南的修订,以及2项针对耐多药结核病患者的接触者TPT的标志性试验的完成。鉴于最新证据及成员国对如何更好地保护结核病高危人群的持续指导需求,WHO启动了指南修订工作,以确保建议的科学性和时效性。2024年9月9日,WHO正式发布了《WHO结核病整合指南模块1：预防--结核病预防性治疗（第二版）》,与此同时,配套的操作手册也一并发布,旨在为指南中各项推荐意见的落地实施提供详尽指导。本文对该指南的核心内容进行解读,以期为我国TPT工作提供参考和借鉴。

关键词: 结核, 预防, 治疗, 指南, 总结性报告

Abstract: Tuberculosis infection (TBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis(MTB) antigens with no evidence of clinically manifest TB disease. Tuberculosis preventive treatment (TPT) for people at risk of tuberculosis can effectively reduce the incidence of TB disease and is a critical measure to achieve the End TB Strategy targets. Since the publication of the 2020 TPT guidelines, several developments have affected TPT policy. They include revision of WHO guidelines on screening for TB disease and new modalities for testing for TBI. In addition, two landmark trials of use of TPT for contacts of people with multidrug-resistant TB have been completed. In the light of these new developments and continued demand from Member States for guidance on how best to protect people at risk of TB, WHO has initiated guidelines revisions to ensure that the recommendations continue to be based on the latest available evidence. On September 9, 2024, WHO published WHO Consolidated Guidelines On Tuberculosis Module 1: Prevention - Tuberculosis Preventive Treatment, second edition, along with an operational handbook to guide the implementation of the recommendations. This article interprets the core content of the 2024 TPT guidelines to provide a reference for the implementation of TPT in China.

Key words: Tuberculosis, Prevention, Treatment, Guidelines, Summary report

中图分类号:

黄嘉敏, 柯学, 李国保, 卢水华. 《WHO结核病整合指南模块1：预防——结核病预防性治疗（第二版）》解读[J]. 新发传染病电子杂志, 2025, 10(3): 92-98.

Huang Jiamin, Ke Xue, Li Guobao, Lu Shuihua. Interpretation of WHO consolidated guidelines on tuberculosis Module 1: prevention-tuberculosis preventive treatment, second edition[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(3): 92-98.

参考文献

[1] COMSTOCK GW, LIVESAY VT, WOOLPERT SF.The prognosis of a positive tuberculin reaction in childhood and adolescence[J]. Am J Epidemiol, 1974, 99(2):131-138.
[2] VYNNYCKY E, FINE PE.Lifetime risks, incubation period, and serial interval of tuberculosis[J]. Am J Epidemiol, 2000, 152(3):247-263.
[3] NEW YORK: UNITED NATIONS. Political declaration of the high-level meeting on the fight against tuberculosis.Resolution A/RES/78/5[EB/OL]. [2023-09-25]. https://digitallibrary.un.org/record/4022582/files/A_78_L.4-EN.pdf?ln=en.
[4] WORLD HEALTH ORGANIZATION.Guidelines on the management of latent tuberculosis infection[EB/OL]. [2015-01-01].https://www.who.int/publications/i/item/9789241548908.
[5] WORLD HEALTH ORGANIZATION.Latent tuberculosis infection: updated and consolidated guidelines for programmatic management[EB/OL]. [2018-02-15].https://www.who.int/publications/i/item/9789241550239.
[6] WORLD HEALTH ORGANIZATION.WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment[EB/OL]. [2020-02-25].https://www.who.int/publications/i/item/9789240001503.
[7] WORLD HEALTH ORGANIZATION.WHO consolidated guidelines on tuberculosis Module 1: prevention-tuberculosis preventive treatment, second edition[EB/OL]. [2024-09-09].https://www.who.int/publications/i/item/9789240096196.
[8] WORLD HEALTH ORGANIZATION.WHO consolidated guidelines on tuberculosis: module 2: screening: systematic screening for tuberculosis disease[EB/OL]. [2021-03-22].https://www.who.int/publications/i/item/9789240022676.
[9] WORLD HEALTH ORGANIZATION.Framework for the evaluation of new tests for tuberculosis infection[EB/OL]. [2020-07-23].https://www.who.int/publications/i/item/ 9789240007185.
[10] WORLD HEALTH ORGANIZATION.WHO consolidated guidelines on tuberculosis: module 3: diagnosis: tests for tuberculosis infection[EB/OL]. [2022-09-30].https://www.who.int/publications/i/item/9789240056084.
[11] THE AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY. The V-QUIN MDR TRIAL: A randomized controlled trial of six months of daily levofloxacin for the prevention of tuberculosis among household contacts of patients with multi-drug resistant tuberculosis[R].2016. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369817.
[12] STELLENBOSCH UNIVERSITY DEPT OF PAEDIATRICS AND CHILD HEALTH. A phase III cluster randomized placebo-controlled trial to assess the efficacy of preventive therapy in child and adolescent contacts of MDR-TB (TB-CHAMP)[R].2016. https://www.isrctn.com/ISRCTN92634082.

[1]	张权武, 王婉如, 卢琼, 辛超. 不同程度肺部受累的单纯肺结核患者免疫内分泌失衡特征分析[J]. 新发传染病电子杂志, 2025, 10(3): 6-11.
[2]	卢春丽, 李艳, 汪敏, 袁园, 黄亚玲, 范佳画. 耐药肺结核患者营养和免疫状态与结核病严重程度的关系[J]. 新发传染病电子杂志, 2025, 10(3): 12-17.
[3]	张琳, 肖海浩, 李天义, 苏雯婕. 疑似肺结核的机化性肺炎患者临床及病理特征分析[J]. 新发传染病电子杂志, 2025, 10(3): 24-28.
[4]	樊冰, 聂勇波, 裴晓改, 李志鹏, 周明, 罗漪, 向琪. 幽门螺杆菌耐药性的现状、机制及应对策略[J]. 新发传染病电子杂志, 2025, 10(3): 72-77.
[5]	李秋萍, 姚伟明, 冯世艳, 林元龙, 王福祥. 耳念珠菌感染的研究进展[J]. 新发传染病电子杂志, 2025, 10(3): 78-83.
[6]	黄献珍, 谭洁, 黄爱春, 朱庆东, 韦柳迎, 谢周华. 2021–2022年南宁市学校结核潜伏感染者预防性治疗效果分析[J]. 新发传染病电子杂志, 2025, 10(2): 19-23.
[7]	周游, 何希, 黄丽花, 罗兰波, 胡敏, 陈桂彬, 刘爱梅, 黄启文, 杨小兵. 结核分枝杆菌RNA检测在耐药肺结核患者疗效监测中的临床价值研究[J]. 新发传染病电子杂志, 2025, 10(2): 24-28.
[8]	孙楠楠, 熊艳美, 杨松, 岑武强, 刘雪艳. 结核性毁损肺相关肺动脉高压患者的临床特点分析[J]. 新发传染病电子杂志, 2025, 10(2): 40-46.
[9]	李敬萍, 刘凯, 卡迪丽娅·阿布都卫力. 合并活动性肺结核的2型糖尿病患者炎性细胞因子表达谱与抗结核治疗失败的相关性研究[J]. 新发传染病电子杂志, 2025, 10(2): 47-53.
[10]	李成坤, 王锦华, 刘志东, 陈浩, 何楚文, 李晓芬, 陈文杰, 林艳伟. 基于数字技术结核病防控管理的卫生经济学评价[J]. 新发传染病电子杂志, 2025, 10(2): 63-69.
[11]	张雅曦, 杨倩婷, 张洁云, 张明霞, 熊欣雨, 陈骑. 组织荧光定量聚合酶链反应联合多方法学在淋巴结结核诊断中的临床应用[J]. 新发传染病电子杂志, 2025, 10(1): 8-11.
[12]	涂志斌, 路亮, 全凯锋, 周亚岚, 况杰, 周显凤, 冯长华, 邱丽萍, 童小琴, 莫佳丽. 南昌市两县区2004–2022年报告丙型肝炎确诊病例HCV RNA持续阳性结果及影响因素分析[J]. 新发传染病电子杂志, 2025, 10(1): 12-16.
[13]	温立旻, 李晔, 李恒星, 林伟, 侯代伦. CT在肺癌与肺癌合并肺结核鉴别诊断中的应用价值[J]. 新发传染病电子杂志, 2025, 10(1): 17-21.
[14]	吕柳英, 梁月新, 张凯, 曾慧频, 黄丽花, 黄俊理, 刘爱梅. 广西地区585例耐多药/利福平耐药结核患者的治疗转归影响因素分析[J]. 新发传染病电子杂志, 2025, 10(1): 22-26.
[15]	吴玉珊, 张绿浪, 黄锐, 李梅, 张声恋, 林润英, 刘敏. 艾滋病合并结核性脑膜炎患者不同剂量利福平治疗方案的真实世界研究[J]. 新发传染病电子杂志, 2025, 10(1): 27-31.

《WHO结核病整合指南模块1：预防——结核病预防性治疗（第二版）》解读

Interpretation of WHO consolidated guidelines on tuberculosis Module 1: prevention-tuberculosis preventive treatment, second edition

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价