全血γ-干扰素释放试验对结核性脑膜炎的早期辅助诊断价值探讨

发布时间：2018-04-16 00:04

本文选题：结核分枝杆菌γ-干扰素释放试验 + 结核性脑膜炎　；参考：《中国感染控制杂志》2017年09期

【摘要】：目的评价外周血结核分枝杆菌γ-干扰素体外释放试验(TB-IGRA)对结核性脑膜炎早期辅助诊断的价值。方法收集2015年1—12月四川大学华西医院住院治疗的56例结核性脑膜炎患者(实验组)及56例非结核性脑膜炎患者(对照组)的TB-IGRA、脑脊液结核分枝杆菌培养、脑脊液TB-DNA的检查结果,计算各诊断方法的灵敏度和特异度。结果 TB-IGRA、脑脊液培养、脑脊液TB-DNA诊断结核性脑膜炎的灵敏度分别为87.5%(49/56)、19.6%(11/56)、60.7%(34/56),特异度分别为89.3%(50/56)、100.0%(56/56)、76.8%(43/56)。TBIGRA诊断结核脑膜炎的灵敏度高于脑脊液TB-DNA检查和脑脊液结核分枝杆菌培养,且TB-IGRA特异度高于脑脊液TB-DNA(89.3%76.8%),三者两两相比,差异均具有统计学意义(均P0.01)。其中脑脊液培养确诊的11例病例中,有10例TB-IGRA阳性,阳性率为90.9%(10/11);45例临床诊断+抗结核治疗有效的病例中,TB-IGRA阳性39例,阳性率为86.7%(39/45)。结论 TB-IGRA协助结核性脑膜炎患者的早期诊断具有高灵敏度和特异度,其检查方便、快速、有效,值得临床推广。
[Abstract]:Objective to evaluate the value of peripheral blood mycobacterium tuberculosis interferon 纬 release assay (TB-IGRA) in the early diagnosis of tuberculous meningitis.Methods from January to December 2015, 56 patients with tuberculous meningitis (experimental group) and 56 patients with non-tuberculous meningitis (control group) who were hospitalized in Huaxi Hospital of Sichuan University were collected and cultured with Mycobacterium tuberculosis in cerebrospinal fluid (CSF).The results of cerebrospinal fluid (TB-DNA) examination were used to calculate the sensitivity and specificity of each diagnostic method.Results the sensitivity of TB-IGRA, CSF culture, cerebrospinal fluid TB-DNA in the diagnosis of tuberculous meningitis was 87.550% 49 / 56 and 19.60.70%, respectively. The specificity of TB-IGRAA, CSF culture and cerebrospinal fluid TB-DNA in diagnosing tuberculous meningitis was higher than that in cerebrospinal fluid (TB-DNA) examination and cerebrospinal fluid mycobacterium culture (CSF). The specificity of TB-IGRAA was 89.3r / 560.00.56% 5676.843 / 565.TBIGRA was higher than that of cerebrospinal fluid TB-DNA examination and cerebrospinal fluid mycobacterium culture, and the sensitivity of TB-IGRA in the diagnosis of tuberculous meningitis was higher than that of CSF TB-DNA examination and CSF mycobacterium culture.The specificity of TB-IGRA was higher than that of TB-DNA in cerebrospinal fluid (TB-DNA) 89.3v.8.The differences among the three groups were statistically significant (all P 0.01).Of the 11 cases confirmed by cerebrospinal fluid culture, 10 cases were TB-IGRA positive, and the positive rate was 90.910 / 11 / 45 cases. 39 cases were TB-IGRA positive, and the positive rate was 86.7% / 45%.Conclusion TB-IGRA has high sensitivity and specificity in the early diagnosis of tuberculous meningitis.
【作者单位】：四川大学华西医院;绵竹市人民医院;
【分类号】：R529.3

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