IGRA及TB-PCR在肠结核与克罗恩病鉴别诊断中的价值  

Value of interferon-γ release assay and polymerase chain reaction for Mycobacterium tuberculosis in differentiation of intestinal tuberculosis from Crohn's disease

作　　者：张俊 高峰 

机构地区：[1]新疆自治区人民医院消化内科

出　　处：《世界华人消化杂志》2014年第4期527-532,共6页World Chinese Journal of Digestology

摘　　要：中国是结核病高负担国家之一,加之目前我国克罗恩病(Crohn's disease,CD)患者数量在逐步增加,而肠结核(intestinal tuberculosis,ITB)和CD的临床表现、放射学检查及内镜检查结果等方面有时很相似.两者的鉴别有时很困难,然而两者的治疗方案及预后截然不同.除了从传统的临床表现、放射学检查、内镜检查、组织病理学检查、抗酸染色、结核分枝杆菌培养、血清标志物及结核菌素皮肤试验(tuberculin skin test,TST)等方面鉴别这两种疾病,近年来的研究用γ干扰素释放分析(interferon-γrelease assay,IGRA)及结核分枝杆菌聚合酶链反应(polymerase chain reaction for Mycobacterium tuberculosis,TB-PCR)来鉴别ITB与CD.在鉴别ITB和CD时,IGRA及TBPCR诊断ITB的敏感度及特异度均较高.本文就IGRA与TB-PCR在鉴别ITB和CD中的价值进行综述.China is one of the countries having the highest burden of tuberculosis. The number of patients with Crohn＇s disease （CD） is gradually increas- ing in China. Sometimes intestinal tuberculosis （ITB） and CD are quite similar in clinical mani- festations and the findings of radiological and endoscopic examinations, and it is difficult to differentiate the two diseases; however, the treatments and prognosis of the two diseases are completely different. Besides clinical charac- teristics, radiological examinations, endoscopic examinations, histopathological examinations, acid-fast staining, Mycobacterium tuberculosis culture, serum markers and tuberculin skin test （TST）, interferon-γ release assay （IGRA） and polymerase chain reaction for Mycobacterium tuberculosis （TB-PCR） have recently been used to differentiate ITD from CD. Both IGRA and TB-PCR have a high sensitivity and specificity in di- agnosis of ITB when differentiating ITB from CD. This review focuses on the value of IGRA and TB- PCR in the differentiation of ITB from CD.

关 键 词：γ干扰素释放分析 结核分枝杆菌聚合酶链反应 肠结核 克罗恩病 鉴别诊断 

分 类 号：R574[医药卫生—消化系统]