γ-干扰素释放试验对儿童结核性脑膜炎的诊断价值

发布时间：2018-07-27 12:26

【摘要】：目的探讨γ-干扰素释放试验(IGRAs)对儿童结核性脑膜炎的诊断价值。方法采用前瞻性病例对照研究方法,比较2012年6月至2013年12月住院的32例结核性脑膜炎患儿(TBM组)和30例非结核性颅内感染患儿(非TBM组)的IGRAs、结核菌素皮肤试验(TST)、结核杆菌抗体(TB-Ig G)及脑脊液结核分枝杆菌DNA(TB-DNA)阳性率的差异,以及各指标的灵敏度、特异度、阳性预测值和阴性预测值。结果 IGRAs、TST、TB-Ig G、脑脊液TB-DNA,在TBM组的阳性率分别为87.50%、56.25%、46.88%、34.38%,非TBM组为6.67%、23.33%、20%、0%,差异均有统计学意义(P0.05)。IGRAs、TST、TB-Ig G、TB-DNA的灵敏度分别为87.5%、56.25%、46.88%、34.38%,特异度分别为93.33%、76.67%、80.00%、100%,各指标灵敏度和特异度的差异均有统计学意义(P0.05);IGRAs的灵敏度高于其他三项指标,差异均具有统计学意义(P0.017)。IGRAs、TST、TB-Ig G、TB-DNA的阳性预测值分别93.33%、72%、71.43%、100%,阴性预测值分别为87.50%、62.16%、58.54%、58.82%。结论 IGRAs、TST、TB-Ig G、TB-DNA对结核性脑膜炎都具有诊断价值,IGRAs的灵敏度和特异度相对较高。
[Abstract]:Objective to evaluate the diagnostic value of interferon-纬 release test (IGRAs) in children with tuberculous meningitis. Methods A prospective case-control study was conducted. A comparison was made between 32 children with tuberculous meningitis (TBM group) and 30 children with non-tuberculous intracranial infection (non-TBM group) from June 2012 to December 2013. The tuberculin skin test (TST), mycobacterium tuberculosis antibody (TB-Ig G) and cerebrospinal fluid tuberculosis (CSF) were compared. The difference of DNA (TB-DNA) positive rate in Mycobacterium And the sensitivity, specificity, positive predictive value and negative predictive value of each index. Results the positive rates of TB-Ig G and TB-DNA in cerebrospinal fluid in TBM group were 87.50 and 56.256.8834.38, respectively, and in non-TBM group it was 6.670.23.330.The difference was statistically significant (P0.05). The sensitivity of IGRASTSTTB-Ig TB-TB-DNA was 87.56.256.250.The specificity was 93.3376.6780.There were significant differences in the sensitivity and specificity of each index. The sensitivity of IGRAs was higher than that of the other three indexes. The positive predictive values of TB-Ig TB-DNA were 93.33 and 72.43, respectively, and the negative predictive values were 87.505.68.54 and 58.82, respectively. Conclusion the TB-Ig TB-DNA of IGR AST has high sensitivity and specificity in the diagnosis of tuberculous meningitis.
【作者单位】：四川省医学科学院四川省人民医院儿科;四川省医学科学院四川省人民医院免疫室;四川省阿坝州人民医院儿科;
【分类号】：R529.3

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