γ干扰素释放试验在结核病诊断中的应用价值  

Diagnostic value of interferon-γ release assay in tuberculosis

作　　者：陈晶[1] 张裕娴 芮勇宇[1] CHEN Jing;ZHANG Yuxian;RUI Yongyu(Department of Laboratory Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院检验科,广州510515

出　　处：《中国感染与化疗杂志》2020年第3期255-258,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析γ干扰素释放试验(IGRA)在结核病诊断中的应用价值。方法收集2017年11月-2019年1月广州南方医院796例进行IGRA检测的住院患者资料,分析IGRA对结核病的诊断价值,并将其与痰涂片抗酸染色镜检、结核抗体胶体金法、结核分枝杆菌DNA荧光定量PCR法、结核菌素皮肤试验(TST)、结核分枝杆菌感染T细胞斑点试验(T-SPOT.TB)进行比较。结果 IGRA对肺结核和肺外结核检出阳性率分别为80.2%和84.1%,差异无统计学意义(P>0.05);肺结核组与非结核组阳性率差异有显著统计学意义(P<0.01)。IGRA对结核诊断的灵敏度、特异度、阳性预测值和阴性预测值分别为 81.9%、81.3%、60.1%和92.9%。痰涂片抗酸染色镜检、结核抗体胶体金法、结核分枝杆菌DNA荧光定量PCR法、TST、T-SPOT.TB的灵敏度分别为3.4%、21.1%、15.2%、66.7%、82.9%。结论 IGRA灵敏度和阴性预测值较好,对结核辅助诊断具有较高临床应用价值。Objective To analyze the utility of interferon-γ release assay (IGRA) in diagnosis of tuberculosis.Methods A total of 796 hospitalized patients with IGRA result were collected from November 2017 to January 2019 in Nanfang Hospital.We analyzed the diagnostic value of IGRA in tuberculosis in comparison with sputum smear,tuberculosis antibody test,fluorescence quantitative polymerase chain reaction (FQ-PCR),tuberculin skin test (TST),and T-SPOT.TB.Results The positive rate of IGRA was 80.2% in diagnosis of pulmonary tuberculosis and 84.1% in identifying extra-pulmonary tuberculosis (P>0.05).But the positive rate was significantly different between pulmonary tuberculosis group and non-tuberculosis group (P<0.01).The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of IGRA were 81.9%,81.3%,60.1%,and 92.9% respectively in diagnosis of tuberculosis.The sensitivity of sputum smear,tuberculosis antibody IgG test,FQ-PCR,TST,and T-SPOT.TB was 3.4%,21.1%,15.2%,66.7%,and 82.9%,respectively.Conclusions IGRA can provide valuable utility in diagnosis of tuberculosis due to better sensitivity and NPV than other diagnostic methods.

关 键 词：Γ干扰素释放试验 结核病 诊断价值 

分 类 号：R446[医药卫生—诊断学] R521[医药卫生—临床医学]