γ-干扰素释放试验在不同类型肺结核中的应用价值

发布时间：2018-06-11 10:03

本文选题：γ-干扰素释放试验 + 肺结核　；参考：《第三军医大学学报》2017年20期

【摘要】：目的探讨γ-干扰素释放试验(interferon-gamma release assay,IGRA)在不同类型肺结核中的应用价值。方法收集2015-2016年于我院及重庆市人民医院1 449例住院患者,分析和比较IGRA在肺结核、活动性肺结核、陈旧性肺结核、特殊人群肺结核、其他肺病中的灵敏度。结果 IGRA对肺结核的灵敏度为84.4%,与其他肺病组比较差异有统计学意义(P0.05);其对活动性肺结核灵敏度(85.6%)与陈旧性肺结核(79.7%)比较差异无统计学意义(P0.05);菌阳肺结核、菌阴肺结核的灵敏度分别为85.1%、86.6%,两组比较差异无统计学意义(P0.05);其中痰涂片阳性但IGRA阴性者25例,菌种鉴定为结核分枝杆菌20例(80%),非结核分枝杆菌5例(20%);4例孕妇合并肺结核IGRA均阳性(100%)。结论 (1)单用IGRA不能鉴别陈旧性肺结核与活动性肺结核,应联合其他检测手段;(2)若菌阳但IGRA阴性的肺疾病患者要考虑病原菌为非结核分枝杆菌的可能,应进一步行分枝杆菌菌种鉴定;(3)既往无结核病史的特殊人群(如孕妇)IGRA阳性有利于辅助诊断活动性结核病。
[Abstract]:Objective to investigate the clinical value of interferon-gamma release assayIGRAA in different types of pulmonary tuberculosis. Methods the sensitivity of IGRA in pulmonary tuberculosis, active pulmonary tuberculosis, old pulmonary tuberculosis, special population tuberculosis and other pulmonary diseases were analyzed and compared in our hospital and Chongqing people's Hospital from 2015 to 2016. Results the sensitivity of IGRA to pulmonary tuberculosis was 84.4%, which was significantly higher than that of other pulmonary diseases group (P 0.05). The sensitivity of IGRA to active pulmonary tuberculosis was 85.6% (P < 0.05), and there was no significant difference between IGRA group and old pulmonary tuberculosis group (79.7%). The sensitivity of bacterio-negative pulmonary tuberculosis was 85.1% and 86.6% respectively, and there was no significant difference between the two groups (P 0.05), among which 25 cases were sputum smear positive but IGRA negative. Mycobacterium tuberculosis was identified as Mycobacterium tuberculosis in 20 cases, Mycobacterium tuberculosis in 5 cases and in pregnant women with pulmonary tuberculosis in 4 cases. All of them were positive for IGRA. Conclusion (1) IGRA alone can not distinguish old pulmonary tuberculosis from active pulmonary tuberculosis, and should be combined with other detection methods. Further identification of Mycobacterium species should be carried out in a special population with no history of tuberculosis (such as pregnant women with IGRA positive is helpful for auxiliary diagnosis of active tuberculosis.
【作者单位】：重庆医科大学附属第二医院呼吸内科;重庆市人民医院呼吸内科;
【基金】：重庆市卫生计生委医学科研计划重点项目(2015ZDXM013)~~
【分类号】：R521

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