γ干扰素释放试验和结核菌素皮肤试验对活动性结核病与结核感染诊断价值的Meta分析  

A meta-analysis of interferon gamma release and tuberculin skin test in the diagnosis of active tuberculosis and tuberculosis infection

作　　者：雷丹 陈羽 王功茴 刘兴会 刘权贤 刘梅 LEI Dan;CHEN Yu;WANG Gong-hui;LIU Xing-hui;LIU Quan-xian;LIU Mei(Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]贵州省遵义医科大学附属医院PCCM结核病区

出　　处：《中华医院感染学杂志》2019年第20期3056-3062,共7页Chinese Journal of Nosocomiology

基　　金：贵州省卫生计生委科学技术基金资助项目(gzwjkj2014-2-172);遵义市科技局立项基金资助项目[遵市科合社字(2014)64号]

摘　　要：目的探讨γ干扰素释放试验(Interferon gamma release assays,IGRAs)和结核菌素皮肤试验(Tuberculin skin test,TST)在我国活动性结核病和结核感染中的诊断效果,为临床检测肺结核提供参考。方法检索NCBI PubMed、万方、中国知网(CNKI)和中国生物医学文献数据库(CBM)关于IGRAs和/或TST诊断肺结核的报道,检索文献范围2011年1月1日-2018年7月31日,提取研究数据,应用Meta Disc软件进行Meta分析。结果依据纳入排除标准,最终纳入43篇文献,其中有41篇文献报道了IGRAs及26篇报道了TST对肺结核的诊断效果。Meta分析结果显示,IGRAs试验诊断肺结核的敏感度(SEN)、特异度(SPE)、阳性似然比(+LD)、阴性似然比(-LD)以及曲线下面积(SROC AUC)分别为0.88(0.87~0.89)、0.79(0.78~0.80)、5.47(3.98~7.50)及0.15(0.13~0.18)、0.938;TST试验以上指标分别为0.65(0.64~0.67)、0.68(0.66~0.69)、2.03(1.72~2.39)及0.52(0.47~0.58)、0.726。结论与TST实验检测肺结核方法相比,IGRAs试验有着更高的敏感性和特异性,具有一定的临床价值。OBJECTIVE To investigate the diagnostic effect of IGRAs and TST in patients with active tuberculosis and tuberculosis infection,providing reference for clinical detection of pulmonary tuberculosis.METHODS Reports on IGRAs and/or TST diagnosis of pulmonary tuberculosis were retrieved on NCBI PubMed,Wanfang,CNKI and CBM from Jan.1,2011to July 31,2018.Data were extracted for research and were analyzed by Meta-Disc software.Result Accroding to the inclusion/exclusion criteria,43articles were finally included,among which 41articles concerned IGRAs test and 26were TST in tuberculosis diagnosed.RESULTS Meta-analysis showed that summary SEN,SPE,+LD,-LD and SROCAUC of IGRAs test for diagnosis of pulmonary tuberculosis were 0.88(0.87~0.89),0.79(0.78~0.80),5.47(3.98~7.50),0.15(0.13~0.18)and 0.938,respectively.Those parameters of TST were 0.65(0.64~0.67),0.68(0.66~0.69),2.03(1.72~2.39),0.52(0.47~0.58)and 0.726,respectively.CONCLUSIONCompared with the TST test,the IGRAs test has higher sensitivity and specificity,possece potential clinical values.

关 键 词：肺结核 结核菌素皮肤试验 Γ干扰素释放试验 META分析 

分 类 号：R52[医药卫生—内科学]