T淋巴细胞γ-干扰素释放试验在结核病诊断中的应用研究

发布时间：2018-02-03 11:43

本文关键词： 结核 PPD T淋巴细胞 γ-干扰素释放试验　出处：《中华医院感染学杂志》2017年18期 　论文类型：期刊论文

【摘要】：目的探讨结核感染T淋巴细胞γ-干扰素释放试验(TB-IGRAs)用于结核病诊断的研究。方法回顾性分析医院2016年1-9月呼吸内科收治的疑似结核病患者207例,收集疑似结核病患者的TB-IGRAs结果和临床特征等资料;207例疑似结核病患者分为三组进行研究,检测卡介苗纯蛋白衍生物试验(PPD)阳性加做TBIGRAs为PPD阳性检测组75例;检测PPD阴性加做TB-IGRAs为PPD阴性检测组50例;直接检测TB-IGRAs为直接检测组82例;对三组研究病例TB-IGRAs的结果进行比较分析。结果 207例疑似结核患者,131例出院诊断为结核病,PPD阳性检测组TB-IGRAs检测阳性率为76.20%,高于PPD阴性检测组50%(P0.05);PPD阳性检测组高于直接检测组75%,但差异无统计学意义;直接检测组高于PPD试验阴性检测组(P0.05);与PPD阳性检测组比较,直接检测组检测阳性率比较差异无统计学意义;与PPD阴性检测组比较,PPD试验阳性检测组、直接检测组阳性率比较差异有统计学意义(P0.05);PPD阳性检测组TB-IGRAs检测灵敏度为94.10%,特异性为37.50%,AUC为0.67;直接检测组TB-IGRAs检测灵敏度为66.70%,特异性为73.00%,AUC为0.74。结论 PPD试验阳性加做TB-IGRAs可提高结核病的检测灵敏度;PPD试验阳性加做TBIGRAs在结核病的阳性分布与患者直接检测TB-IGRAs无区别;ROC曲线显示TB-IGRAs在结核病中诊断效率低。
[Abstract]:Objective to investigate the release of interferon 纬 (IFN 纬) from T lymphocytes infected with tuberculosis (TB-IGRAs). Methods 207 suspected tuberculosis patients admitted to Department of Respiratory Medicine from 2016 to September in our hospital were analyzed retrospectively. TB-IGRAs results and clinical features of suspected tuberculosis patients were collected. 207 suspected tuberculosis patients were divided into three groups. 75 cases were positive for BCG pure protein derivative test and 75 cases for PPD positive test. There were 50 cases of PPD negative test group with PPD negative and TB-IGRAs; TB-IGRAs was detected directly in 82 cases in the group of direct detection. The results of TB-IGRAs in three study groups were compared and analyzed. Results #number0# patients with suspected tuberculosis were discharged from hospital and diagnosed as tuberculosis. The positive rate of TB-IGRAs in PPD positive group was 76.20, which was higher than that in PPD negative test group (P 0.05). The PPD positive group was higher than that of the direct test group (75%), but the difference was not statistically significant. The direct test group was higher than the PPD test negative group (P 0.05). There was no significant difference in positive rate between direct test group and PPD positive group. The positive rate of direct test group was significantly higher than that of PPD negative group (P 0.05). In PPD positive group, the sensitivity of TB-IGRAs was 94.10 and the specificity was 37.50. AUC was 0.67; The sensitivity of TB-IGRAs in the direct detection group was 66. 70 and the specificity was 73.00%. AUC was 0.74. Conclusion positive PPD test plus TB-IGRAs can improve the sensitivity of tuberculosis detection. There was no difference between the positive distribution of PPD test plus TBIGRAs in tuberculosis and the direct detection of TB-IGRAs in patients. ROC curve showed that TB-IGRAs was less effective in diagnosis of tuberculosis.
【作者单位】：绍兴市立医院检验科;
【基金】：绍兴市卫生计生委成果转化项目(2016ZH003)
【分类号】：R446.6;R52
【正文快照】： 目前多个国家已将结核感染T淋巴细胞γ-干扰素释放试验(TB-IGRAs)用于诊断结核潜伏期感染(LTBI),我国部分三级甲等专科医院已常规开展此项检测,多家TB-IGRAs试剂已经或即将进入临床应用。我国是结核病高发国家之一,2010年全国抽样调查结果显示,全国≥15岁人口中活动性肺结核患

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