全血γ干扰素释放试验诊断结核病的临床应用价值  

The diagnosis value of the whole blood interferon-γ release assay in tuberculosis

作　　者：孔海芳 岳娜[1] 刘刚[2] 李妍淳[1] 田彬[1] 胡志东[1] 

机构地区：[1]天津医科大学总医院医学检验科,300052 [2]天津市海河医院检验科

出　　处：《天津医药》2016年第9期1132-1135,共4页Tianjin Medical Journal

摘　　要：目的：评价全血γ干扰素（IFN-γ）释放试验（QFT-GIT）诊断结核病的临床应用价值。方法收集天津医科大学总医院2014年10月—2015年10月109例（确诊病例45例，临床诊断病例64例）结核病患者（结核组）和70例非结核呼吸系统疾病患者（非结核组）资料，同时采用QFT-GIT、胶体金抗结核抗体（TB-Ab）进行检测，绘制IFN-γ释放量受试者工作者特征（ROC）曲线，比较2种方法的诊断价值及QFT-GIT试验在2组中的差异。结果QFT-GIT对结核病的诊断敏感度为93.58%，特异度为85.71%，其诊断阳性率高于TB-Ab（χ^2=43.68，P＜0.01）。2种方法联合检测的敏感度降至52.29%（57/109），但特异度增加至90.00%（63/70）。结核组IFN-γ释放量明显高于非结核组（U=330，P＜0.05），IFN-γ释放量ROC曲线下面积为0.913（95%CI：0.864-0.963）。结论 QFT-GIT试验在结核病诊断中具有较高的敏感度和特异度，与TB-Ab联合检测可进一步提高诊断的特异度，为临床结核病的诊断提供及时有效的依据。Objective To evaluate the clinical application of the whole blood interferon γ （IFN-γ） release assay ofQuantiFERON TB Gold in tube （QFT-GIT） in diagnosis of tuberculosis. Methods From October 2014 to October 2015,109 patients with tuberculosis （45 cases of confirmed patients and 64 cases of clinically diagnosed patients） and 70 patientswith non-tuberculosis were enrolled in Tianjin Medical University General Hospital. In order to evaluate diagnosis valuebetween two kinds of tests, and to compare the differences between two groups, QFT- GIT test and colloidal gold antituberculosis antibody （TB-Ab） were employed to detect in two groups of patients. The ROC curve of IFN-γ release quantitywas analyzed in two groups. Results The sensitivity and specificity of QFT-GIT were 93.58% and 85.71% respectively.The positive rate was significantly higher in QFT-GIT than that of TB-Ab （χ^2=43.68,P〈0.01）. The sensitivity of combineddetection of the two methods decreased to 52.3% （57/109）, but the specificity increased to 90.0% （63/70）. The releasequantity of IFN-γ was significantly higher in tuberculosis group than that in the non-tuberculosis group （U=330,P〈0.05）.The area under the ROC curve of IFN-γ release quantity was 0.913 （95%CI： 0.864-0.963）. Conclusion The whole bloodIFN-γ release assay of QFT-GIT is a sensitive and specific assay for detecting tuberculosis infection. The combination QFTGITwith TB-Ab can improve the specificity further, which could be a useful tool for the diagnosis of tuberculosis.

关 键 词：结核 卡介苗 诊断试验 常规 敏感性与特异性 ROC曲线 Γ干扰素释放试验 结核抗体 

分 类 号：R446.51[医药卫生—诊断学] R52[医药卫生—临床医学]