INF-γ,ADA,抗结核抗体联合测定在菌阴肺结核患者中的应用价值  

Application Value of Determination of Patients With Smear-positive Pulmonary Tuberculosis by Combination of Anti-TB Antibody,INF-γ and ADA

作　　者：伏俊[1] 房三友[1] 闻寅[1] 王道峰[1] 朱晓兰[1] 

机构地区：[1]扬州大学附属医院呼吸内科,江苏泰兴225400

出　　处：《职业卫生与病伤》2014年第4期231-233,共3页Occupational Health and Damage

摘　　要：目的探讨菌阴肺结核患者全血浆中γ干扰素(INF-γ)、腺苷脱氨酶(ADA)和抗结核抗体检测结果,指导临床抗结核治疗提供依据。方法 2012-04收集40例肺部感染疑似肺结核病例,其中临床正规抗感染(非抗结核)治疗半个月病灶不吸收患者(确认为菌阴肺结核组,简称结核组)22例,抗感染(非抗结核)治疗半月病灶有效吸收患者(确认为非菌阴肺结核即其它肺炎组,简称肺炎组)18例。γ-干扰素释放试验(IGRA)对两组患者检测测定INF-γ,临床常规方法检测患者的ADA和抗结核抗体,结果进行比较分析。结果检测INF-γ的T-SPOT.TB(T细胞斑点试验)阳性率结核组为90.9%,较肺炎组的阳性率(11.1%)高,差异有统计学意义(χ2=7.111 2,P=0.007 7);ADA(腺苷脱氨酶)结核组均值(38.6±2.6)高于肺炎组(18.6±1.5),差异有统计学意义(t=28.896 8,P=0.000 0);抗结核抗体阳性率结核组(27.3%)高于肺炎组(16.7%),但差异无统计学意义(χ2=0.622 7,P=0.430 1)。结论γ-干扰素释放试验(IGRA)具有很高的特异性,明显高于传统试验,对菌阴肺结核患者指导临床抗结核治疗有重要的应用价值。Objective To study the test results of INF-γ interferon（ in whole plasma γ interferon）,ADA（ adenosine deaminase） and anti-TB antibody in whole plasma of patients with Smear-positive pulmonary tuberculosis,provide the basis for clinical anti tuberculosis treatment.Methods 40 cases of suspected cases of tuberculosis with lung infection were collected during April 2012,among which 22 cases of patients with half a month＇s clinical anti-infection treatment but not absorb,which are recognized as group of smear-positive pulmonary tuberculosis,abbreviated as TB group.However,18 cases of the patients with effective absorption by a half month＇s treatment were diagnosed as non-smear-positive pulmonary tuberculosis,viz.other pneumonia group,which abbreviated as pneumonia group.The results were compared and analyzed between INF-γ of two groups were detected by γ interferon（ IGRA） and test of ADA in addition to anti-TB antibody by normal clinical means.Results The positive rate of T-SPOT.TB by INF-γ test in TB group was90. 9% which is above than pneumonia group with 11. 1%,the deference between two groups have statistical significance（ χ2= 7. 111 2,P = 0. 007 7）; Average value（ 38. 6 ±2. 6） of ADA（ adenosine deaminase） for TB group was above than pneumonia group（ 18. 6 ± 1. 5）,the deference between two groups have statistical significance（ t = 28. 896 8,1 P =0. 000 0）; The positive rate of anti-body in TB group（ 27. 3 %） is above the pneumonia group（ 16. 7 %）.Conclusion Test of INF-γ（ IGRA） interferon has high significance which is above the traditional test,and has significant value of anti-TB clinical treatment of patient with pulmonary tuberculosis.

关 键 词：γ-干扰素(INF-γ) 菌阴结核 

分 类 号：R521[医药卫生—内科学]