γ-干扰素释放试验在肺外结核诊断中的应用与评价

发布时间：2019-05-23 05:15

【摘要】：目的探讨γ-干扰素释放试验(T细胞斑点试验)在肺外结核诊断中的使用效能。方法通过对265例入组的肺外结核疑似患者进行T细胞斑点试验检测,分析该技术在肺外结核中的诊断效能和影响该检测结果的风险因素。结果 265例患者中,确诊肺外结核147例、可疑肺外结核32例、排除结核感染86例。在去除可疑样本之后,T细胞斑点试验灵敏度和特异性分别为81%和53%。其中,T细胞斑点试验对淋巴结核与结核性腹膜炎检测灵敏度最高,均为88%;结核性胸膜炎检测的灵敏度最低,为75%;T细胞斑点试验对淋巴结核检测的特异性最高,为67%;而肠结核检测的特异性最低,仅为44%。在免疫功能低下人群中,其灵敏度较免疫功能正常人群显著降低(P0.05)。此外,年龄(≥65岁)对T细胞斑点试验灵敏度及对阳性预测值和阴性预测值的影响具有统计学意义(P0.05)。结论 T细胞斑点试验能够作为疑似肺外结核鉴别的辅助诊断工具,具有较高的灵敏度,但在不同感染部位的检测效能不同。T细胞斑点试验检测结果受到患者免疫功能状态与年龄的影响,因此在进行该项检测之前有必要对患者免疫状态等相关因素进行评估。
[Abstract]:Objective to investigate the efficacy of interferon gamma release test (T cell dot test) in the diagnosis of extrapulmonary tuberculosis. Methods the diagnostic efficacy of this technique in extrapulmonary tuberculosis and the risk factors affecting the results were analyzed by T cell dot test in 265 suspected patients with extrapulmonary tuberculosis. Results among 265 patients, 147 cases were diagnosed as extrapulmonary tuberculosis, 32 cases as suspected extrapulmonary tuberculosis and 86 cases as excluding tuberculosis infection. After removing suspicious samples, the sensitivity and specificity of T cell dot test were 81% and 53%, respectively. Among them, the sensitivity of T cell dot test was the highest in both lymphoid tuberculosis and tuberculosis peritonitis (88%), and the sensitivity of tuberculosis pleurisy was the lowest (75%). The specificity of T cell dot test for detection of lymphoid tuberculosis was the highest (67%), while that of intestinal tuberculosis was the lowest (44%). In the population with low immune function, the sensitivity was significantly lower than that in the population with normal immune function (P 0.05). In addition, age (鈮，

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