体外γ-干扰素释放试验在儿童结核病密切接触者筛查结核病的作用  

Role of IGRA in screening of tuberculosis for children with close TB contacts

作　　者：黎燕琼[1] 谭守勇[1] 刘志辉[1] 谭耀驹[1] 黄艳君[1] 孔少颜[1] 

机构地区：[1]广州市胸科医院、呼吸疾病国家重点实验室,510095

出　　处：《实用医学杂志》2015年第15期2463-2466,共4页The Journal of Practical Medicine

基　　金：国家“十二五”重大科研项目(编号:2012ZX100004903-001-002);广东省科技计划项目(编号:2012A030400002)

摘　　要：目的:探讨体外γ-干扰素释放试验(IGRA)在儿童结核病密切接触者结核病筛查的可行性。方法:对我院儿科门诊就诊185例儿童结核病密切接触者采用IGRA检测,对其与结核病诊断相关性进行分析。结果:IGRA阳性组中,儿童结核病密切接触者PPD强阳性率(PDD≥15 mm)为50.9%,明显高于IGRA阴性组的9.1%(χ2=37.263,P<0.00);IGRA阳性组中,儿童结核病密切接触者发病率为30.2%,明显高于IGRA阴性组的3.0%(χ2=28.928,P<0.00);IGRA在儿童筛查结核病敏感性为80.0%,特异性为77.6%;联合TST检测其敏感性达到95.0%。结论:对儿童结核病密切接触者开展IGRA筛查,可提高患者发现率和减少儿童结核病密切接触者影像学筛查。Objective To study the feasibility of in vitro release of γ-interferon tests （IGRA） in screening of tuberculosis for children with close TB contacts. Methods 185 children with close TB contacts were detected by IGRA at the pediatric clinic in our hospital. Results In IGRA-positive group, the rate of strong positive PPD （PDD ≥ 15 mm） was 50.9%, which was higher than 9.1% in IGRA-negative group （x^2 = 37.263, P 〈 0.00）. The morbidity rate for children with close TB contacts was 30.2% in IGRA-positive group, and it was significantly higher than 3.0% in IGRA-negative group （x^2 = 28.928, P 〈 0.00）. The sensitivity was 80% and the specificity was 77.6% for IGRA screening in children who had close contacts with TB patients. The sensitivity would be 95.0%, as the test was combined with PPD test. Conclusions IGRA screening in children with close TB contacts can increase the detection rate of tuberculosis and reduce imaging screening.

关 键 词：结核病 Γ-干扰素释放试验 密切接触者 儿童 

分 类 号：R529.9[医药卫生—内科学]