γ干扰素释放试验检测诊断类风湿关节炎患者潜伏性结核感染价值的荟萃分析  

Diagnostic value of T-SPOT.TB for latent tuberculosis infection in patients with rheumatoid arthritis:a Meta-analysis

作　　者：李远[1] 王晶[1] 侯婷婷[1] 周正[2] 杨琳 LI Yuan;HOU Tingting;ZHOU Zheng(Department of Clinical Laboratory,Shandong Provincial Hospital Affiliated to Shandong University,Jinan,250021,China)

机构地区：[1]山东大学附属省立医院检验部,250021 [2]山东省胸科医院检验科

出　　处：《浙江医学》2018年第16期1859-1863,1867,共6页Zhejiang Medical Journal

摘　　要：目的通过Meta分析系统评价在类风湿关节炎(RA)患者中γ干扰素释放试验(IGRAs)用于快速检测潜伏性结核感染的诊断价值。方法按照系统评价的要求检索Medline、Pub Med、EMBASE、万方医学网、中国期刊全文数据库(CNKI),获得关于IGRAs试验诊断RA患者中潜伏性结核感染的临床文献,对其进行Meta分析。结果纳入文献共19篇(患者共4789例),卡介苗(BCG)接种率范围(2.8%~83%),T细胞斑点检测(T-SPOT.TB)与结核菌素皮肤试验(TST)优势比(OR)为1.96(95%CI:1.65~2.33,P<0.05),潜伏性结核感染诊断(QFT)与TST的OR为1.38(95%CI:1.20~1.60,P<0.05),QFT与T-SPOT.TB的OR为1.39(95%CI:0.98~1.97,P>0.05)。结论 TST试验因受BCG接种的影响,诊断效能较低,IGRAs方法可避免BCG接种的影响,因此,在RA患者中可以使用IGRAs方法更确切的诊断潜伏结核患者,本试验的资料有限还需更多的临床资料的验证。Objective To assess the diagnostic value of T-SPOT.TB for latent tuberculosis infection CNKI,in in The patients and with rheumatoid library arthritis（AR）by a systematic review.Methods using The database PubMed,EMBASE,Medline,VIP Cochrane patients.were searched search to evaluate the evidence of T-SPOT.TB 4789 for diagnosis of latent tuberculosis rate infection RA Results T-The identified was 19 eligible studies including patients.BCG coverage was 2.8%-83%.Odds ratio of SPOT.TB vs TST QFT 1.96（95%CI：1.65-2.33,P〈0.05）,the Odds ratio of QFT vs TST was 1.38（95%CI：1.20-1.60,P〈0.05）,the Odds low,ratio but of vs T-SPOT.TB could was avoid 1.39（95%CI：0.98-1.97,the P〈0.05）.Conclusion The effect of BCG vaccination on TST test is TB theT-SPOT.TB infection impact of BCG the vaccination.Thus,be the T-SPOT.TB further is effective in diagnostic latent studies.tuberculosis in patients with RA.However,results need to confirmed by large scale high quality

关 键 词：Γ干扰素 结核 类风湿关节炎 结核菌素试验 

分 类 号：R446.6[医药卫生—诊断学] R593.22[医药卫生—临床医学]