结核病是全世界面临的健康挑战之一,是人类单一病原体感染性疾病致死的最重要原因。世界卫生组织报道2011年全球约有870万新发结核感染病例,其中13%合并HIV感染,140万例死于结核病;儿童患者约有50万例,6.4万例死于结核病[1]。淋巴结结核是最常见的肺外结核,占所有结核病的4.0%~5.1%,占肺外结核的20.3%~50.0%,传染途径多为淋巴血行播散,可累及多组淋巴结,最多见于颈、腋下、腹股沟及颌下淋巴结。淋巴结结核通常表现为多个淋巴结肿大、而无结核病全身的症状及体征,因此其诊断有赖于对该病的高度的临床警觉性及实验室、病理学检查[2]。目前多通过采集病史、体格检查、结核菌素试验、影像学检查、细针穿刺检查、组织学检查等作出诊断。WHO(2009年)提出的儿童淋巴结结核推荐治疗方案同肺结核治疗方案,即2HRZE/4HR[3]:2个月的异烟肼(H)+利福平(R)+吡嗪酰胺(Z)+乙胺丁醇(E)强化治疗,随后4个月的异烟肼(H)、利福平(R)巩固治疗。17 Tuberculosis is one of the health challenges facing the world and is the single most important cause of death from infectious diseases of a single human pathogen. WHO reports about 8.7 million new cases of tuberculosis infection worldwide in 2011, of which 13% were HIV-infected and 1.4 million died of tuberculosis. About 500,000 children and 64,000 deaths from tuberculosis were reported by the World Health Organization [1]. Lymph node tuberculosis is the most common extrapulmonary TB, accounting for 4.0% ~ 5.1% of all tuberculosis, accounting for 20.3% ~ 50.0% of extrapulmonary tuberculosis. Most of the routes of infection are lymphatic spread, which can affect multiple groups of lymph nodes, most often seen in the neck, Armpits, groin and submandibular lymph nodes. Lymph node tuberculosis often presents with multiple lymphadenopathy, but without the symptoms and signs of tuberculosis. Therefore, its diagnosis depends on the high degree of clinical alertness and laboratory and pathological examination of the disease [2]. Mostly through the acquisition of medical history, physical examination, tuberculin test, imaging examination, fine needle aspiration, histological examination to make a diagnosis. The recommended regimen for treating children with lymph node tuberculosis proposed by the WHO (2009) is the same as the tuberculosis regimen, namely 2HRZE / 4HR [3]: 2 months of isoniazid (H) + rifampin (R) + Ethambutol (E) intensive therapy followed by 4-month isoniazid (H), rifampicin (R) consolidation therapy. 17