结核γ-干扰素酶联免疫法释放试验结果及影响相关因素分析  

The release test results of tuberculosis-interferon enzyme-linked immunoassay and the related factors were discussed

作　　者：徐宁[1] 郑瑞[2] 毛小琴 撒亚莲[4] XU Ning;ZHENG Rui;MAO Xiao-qin(Department of clinical laboratory,First People's Hospital of Yuman province,Kunming 650032,China)

机构地区：[1]云南省第一人民医院检验科 [2]云南省临床检验中心 [3]云南省临床微生物重点实验室 [4]云南省第一人民医院临床基础医学研究所,云南昆明650032

出　　处：《中国实验诊断学》2021年第1期89-92,共4页Chinese Journal of Laboratory Diagnosis

基　　金：国家自然科学基金地区科学基金项目(31460298);云南省卫生厅内设机构资助项目(2017NS228);云南省科技厅科技计划项目(2018FE001)。

摘　　要：目的目前结核病诊断方法中,细菌学检查是诊断结核的金标准,但是阳性率较低,结核菌培养耗时长,对肺外结核的诊断阳性率更低,影像学、TST、抗体检测、分子诊断方法等在敏感性和特异性方面均都存在一定的局限性,近年来以T细胞免疫为基础的γ干扰素释放试验(IGRA)被证实在结核分枝杆菌感染检测中具有较好的敏感性和特异性,本研究针对γ-干扰素酶联免疫法释放试验结果及影响因素进行探讨。方法纳入2019年1月至2019年12月云南省第一人民医院门诊及住院患者,且经相关病理及细菌学检查和临床转归而最终证实的结核感染患者516例为阳性组,而阴性组则是疑似结核,最终通过其他检查排除结核患者444例,探讨γ-干扰素释放试验(IGRA)临床应用的准确性和特异性,以及实验的影响因素。结果干扰素试验结果和最终病理确诊结果之间比较P值<0.001为差异有统计学意义,在年龄、干扰素释放量、淋巴细胞、CRP、单核细胞等方面差异有统计学意义(P<0.05)。结论γ-干扰素与病理结果有很高的一致性,可作为临床传统影像及病理判断结核方法的有力补充,年龄、干扰素释放量、淋巴细胞、CRP、单核细胞等都是实验结果的影响因素。Objective Current TB diagnosis method,the bacteriology examination is the gold standard in the diagnosis of tuberculosis,but the positive rate is low,training time is long,n/med tuberculosis bacterium of extrapulmonary tuberculosis diagnosis positive rate lower,imaging,TST,antibody detection and molecular diagnostic methods in terms of sensitivity and specificity were all has certain limitation,in recent years on the basis of the T cell immune gamma interferon release test(IGRA)were confirmed in the detection of mycobacterium tuberculosis infection has good sensitivity and specificity,this study aimed at gamma interferon,enzyme-linked immunoassay release test results and influencing factors were discussed.Methods In October 2018 to March 2019 in yunnan province,the first people’s hospital outpatient and inpatient,and by related pathology and bacteriology examination and clinical outcome and finally confirmed 516 cases of patients with TB infection is positive group,and the negative group is suspected TB,ultimately through other check out 444 cases of tuberculosis patients,explore release test(IGRA)clinical application of gamma interferon accuracy and specificity,and the influence factors of the experiment.Results γ-Interferon comparison between experimental results and the final pathology confirmed results p values<0.001 for the difference was statistically significant in age,interferon to release a quantity,lymphocyte,CRP and mononuclear cell difference was statistically significant(P<0.05).Conclusion gamma interferon has high consistency with the pathological results,can be used as a traditional clinical imaging and pathological judgment method is a powerful supplement of TB,and age,interferon to release a quantity,lymphocyte,CRP and monocytes are the influence factors of the experimental results.

关 键 词：干扰素释放 结核(TB) 淋巴细胞计数 使用激素 

分 类 号：R446.61[医药卫生—诊断学]