抗原诱发的γ-干扰素释放试验在结核性胸膜炎中的诊断价值  

Diagnostic value of anti-induced interferon-gama release assays in tuberculous pleurisy

作　　者：乔亚红[1] 张曼林[1] 汤兵祥[1] 石瑞如[1] 尚耀民[1] 

机构地区：[1]河南省胸科医院呼吸内科,郑州450008

出　　处：《中国实用医刊》2014年第16期1-3,共3页Chinese Journal of Practical Medicine

基　　金：河南省2010年度医学科技攻关计划项目（201003136、201001014）

摘　　要：目的：探讨在胸水中检测抗原诱发的γ-干扰素释放反应（ IGRA）在结核性胸膜炎中的诊断价值。方法选取河南省胸科医院胸腔积液患者65例，根据胸膜活检病理结果分为结核组（35例）与肿瘤组（30例），应用酶联免疫吸附试验（ ELISA）检测两组患者血清及胸水中γ-干扰素基础值及经ESAT-6抗原刺激后γ-干扰素释放水平，并对数据进行对比分析，判断γ-干扰素基础值及经ESAT-6抗原刺激后γ-干扰素释放水平对结核性胸膜炎的诊断价值。结果结核组胸水中的γ-干扰素基础值和经ESAT-6抗原刺激后γ-干扰素释放水平均高于血中的γ-干扰素基础值及经ESAT-6抗原刺激后γ-干扰素释放水平，差异有统计学意义（P﹤0.01）。结核组胸水中的γ-干扰素基础值和经ESAT-6抗原刺激后γ-干扰素释放水平均高于恶性胸腔积液组，差异有统计学意义（ P﹤0.05）。结核组血中检测γ-干扰素基础值及经ESAT-6抗原刺激后γ-干扰素释放水平均高于肿瘤组，但差异无统计学意义（ P﹥0.05）。结论结核高感染率的背景下，血中IGRA对于鉴别胸腔积液是肿瘤还是结核意义不大；在胸水中检测IGRA对结核性胸膜炎诊断的方法简便，特异性、灵敏度高，在临床上值得推广使用。Objective To investigate the diagnostic value of pleural fluid interferon-gamma relesse assay（ IGRA）on tuberculous pleurisy. Methods According to the pathological results of pleural biopsy,65 patients with plearal effusion were divided into two groups：tuberculous pleurisy group（35 cases）and malignant pleural effusion group（30 cases）. Enzyme-linked immunosorbent assay（ enzyme linked immunosorbent assay,ELISA）method was used to detect the serum and pleural interferon-γbase level and the interferon-γ release level after ESAT-6 antigen stimulation,the value of interferon-γ base value and interferon-γ release level after the ESAT-6 antigen stimulation on the diagnosis of tuberculous pleuritis was evaluated. Results In tuberculous pleurisy patients,the interferon-γbase value and inter-feron-γ release after the ESAT-6 antigen stimulation was higher than blood interferon-γ basic values and interferon-γ release level after ESAT-6 antigen stimulation（P﹤0. 01）. In tuberculous pleurisy patients, the interferon-γbase value and interferon-γrelease after the ESAT-6 antigen stimulation were higher than that with malignant pleural effusion group（P﹤0. 05）. In tuberculous pleurisy patients,the blood interferon-γ base value and the interferon-γ release after ESAT-6 antigen stimulation were higher than that of malignant pleural effusion group（ P﹥0. 05 ）. Conclusions In the background of hight rate of tuberculosis infection,there is no specificity of interferon-γ release assay（ IGRA）in diagnosis of patients with tumor. Interferon-γ release assay（ IGRA）in the diagnosis of tuberculous pleurisy is simple,sensitive, has high specificity and worthy of clinical application.

关 键 词：Γ-干扰素 ESAT-6 分枝杆菌感染 结核性胸膜炎 

分 类 号：R521.7[医药卫生—内科学]