γ干扰素释放试验假阴性结核性脑膜炎2例分析  

False negative results of interferon-γrelease assays for two cases of tuberculous meningitis

作　　者：杨蕙[1] 闫丽红[2] 尹潇[1] 刘红[1] 孙燕[1] 庄晓亮[1] 张乐研[1] 

机构地区：[1]解放军第107医院检验科,山东烟台264002 [2]青岛大学附属医院档案科,山东青岛266003

出　　处：《中华医院感染学杂志》2016年第21期4891-4893,共3页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项基金资助项目(2013ZX10004203-001-006)

摘　　要：目的探讨结核性脑膜炎患者γ-干扰素释放试验(TB-IGRA)假阴性结果的原因及临床意义,为结核的诊断和鉴别诊断提供依据。方法对2015年5月-9月107医院就诊的两例TB-IGRA假阴性结核性脑膜炎患者的感染学指标及诊断、治疗、预后情况进行综合分析。结果两例患者在接受抗结核治疗后,症状有所好转。其中一例患者三月后TB-IGRA结果转为阳性。结论 T淋巴细胞的"隔室化效应"、感染部位不同等诸多因素,可影响TB-IGRA结果的准确性。OBJECTIVE To explore the causes of false negative results of interferon-7 release assays for patients with tuberculous meningitis and analyze the clinical significance so as to provide guidance for diagnosis and differ- ential diagnosis of tuberculosis. METHODS A total of 2 patients with tuberculous meningitis who were false nega- tive for interferon-γ release assays and treated in the PLA 107th Hospital from May 2015 to Sep 2015 were en- rolled in the study. The infection indexes, diagnosis, treatment, and prognosis were comprehensively analyzed. RESULTS The symptoms of the two patients were improved after the antituherculosis therapy, and one patient turned to be positive for the interferon-γ release assay three months later. CONCLUSION There are a variety of fac- tors such as the sequestration effect of T lymphocytes and different infection sites, which may affect the accuracy of the interferon-γ release assay for the patients with tuberculous meningitis.

关 键 词：Γ干扰素释放试验 假阴性 结核性脑膜炎 

分 类 号：R529.3[医药卫生—内科学]