全血γ干扰素释放试验诊断结核病的临床应用价值

发布时间：2018-11-15 22:34

【摘要】：目的评价全血γ干扰素(IFN-γ)释放试验(QFT-GIT)诊断结核病的临床应用价值。方法收集天津医科大学总医院2014年10月—2015年10月109例(确诊病例45例,临床诊断病例64例)结核病患者(结核组)和70例非结核呼吸系统疾病患者(非结核组)资料,同时采用QFT-GIT、胶体金抗结核抗体(TB-Ab)进行检测,绘制IFN-γ释放量受试者工作者特征(ROC)曲线,比较2种方法的诊断价值及QFT-GIT试验在2组中的差异。结果QFT-GIT对结核病的诊断敏感度为93.58%,特异度为85.71%,其诊断阳性率高于TB-Ab(χ2=43.68,P0.01)。2种方法联合检测的敏感度降至52.29%(57/109),但特异度增加至90.00%(63/70)。结核组IFN-γ释放量明显高于非结核组(U=330,P0.05),IFN-γ释放量ROC曲线下面积为0.913(95%CI:0.864~0.963)。结论 QFT-GIT试验在结核病诊断中具有较高的敏感度和特异度,与TB-Ab联合检测可进一步提高诊断的特异度,为临床结核病的诊断提供及时有效的依据。
[Abstract]:Objective to evaluate the clinical value of whole blood interferon 纬 (IFN- 纬) release test (QFT-GIT) in the diagnosis of tuberculosis. Methods from October 2014 to October 2015, 109 patients with tuberculosis (tuberculosis group) and 70 patients with non-tuberculosis respiratory diseases (non-tuberculosis group) were collected from Tianjin Medical University General Hospital. At the same time, QFT-GIT, colloidal gold anti-tuberculosis antibody (TB-Ab) was used to detect IFN- 纬 emission and the characteristic (ROC) curve was drawn. The diagnostic value of the two methods and the difference of QFT-GIT test in the two groups were compared. Results the sensitivity of QFT-GIT in the diagnosis of tuberculosis was 93.58 and the specificity was 85.71. The positive rate of QFT-GIT was higher than that of TB-Ab (蠂 ~ 2 / 43.68 / P0.01). The sensitivity of the two methods decreased to 52.29% (57 / 109). But the specificity increased to 90.00% (63 / 70). The release of IFN- 纬 in tuberculosis group was significantly higher than that in non-tuberculosis group (P 0.05), and the area under ROC curve of IFN- 纬 emission was 0.913 (95%CI:0.864~0.963). Conclusion QFT-GIT test has high sensitivity and specificity in the diagnosis of tuberculosis. Combined detection with TB-Ab can further improve the specificity of diagnosis and provide a timely and effective basis for the diagnosis of clinical tuberculosis.
【作者单位】：天津医科大学总医院医学检验科;天津市海河医院检验科;
【分类号】：R52;R446.6

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