TB.IGRA在海分枝杆菌感染诊断和鉴别诊断中的应用  

Application of TB.IGRA in the diagnosis and differential diagnosis of Mycobacterium marinum infection

作　　者：李艳艳 王真真[1] 孙远航 潘晴[1] 暴芳芳[1] 王川[1] 杨青[1] 杨宝琦[1] 刘红[1] 张福仁[1] LI Yanyan;WANG Zhenzhen;SUN Yuanhang;PAN Qing;BAO Fangfang;WANG Chuan;YANG Qing;YANG Baoqi;LIU Hong;ZHANG Furen(Shandong Provincial Hospital for Skin Diseases&Shandong Provincial Institute of Dermatology and Veneorology,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院(山东省皮肤病医院),山东省皮肤病性病防治研究所,山东济南250022

出　　处：《中国麻风皮肤病杂志》2022年第5期298-302,共5页China Journal of Leprosy and Skin Diseases

基　　金：山东省高等学校青创科技支持计划(编号:2019KJL003);山东第一医科大学学术提升计划(编号:2019RC007)。

摘　　要：目的:探讨结核感染T细胞γ-干扰素释放实验(TB.IGRA)在海分枝杆菌感染诊断和鉴别诊断中的应用价值。方法:回顾性分析在我院门诊诊疗的疑似海分枝杆菌感染患者,排除结核病患者,根据患者海分枝杆菌qPCR是否阳性分为海分枝杆菌感染组和真菌、普通细菌感染组。应用TB.IGRA检测患者外周血中结核感染特异性T细胞,比较分析TB.IGRA和抗酸染色诊断海分枝杆菌感染的灵敏度、特异度、预测值和似然比;比较不同年龄组中TB.IGRA的灵敏度、特异度差异以及海分枝杆菌感染患者的γ-干扰素水平。结果:共纳入87例海分枝杆菌感染和25例真菌、普通细菌感染患者。TB.IGRA诊断海分枝杆菌感染的灵敏度、特异度分别为73.6%、64.0%,灵敏度较抗酸染色高,特异度较抗酸染色低;其阳性、阴性预测值和似然比分别为87.7%、41.0%、2.04和0.41;青年、中年和老年组的灵敏度分别为70.0%、73.5%、74.4%,中年组特异度最高(88.9%),老年组最低(46.2%)。结论:TB.IGRA在海分枝杆菌感染的诊断和鉴别诊断中具有重要的应用价值。Objective:To investigate the application value of TB.IGRA assay in the diagnosis and differential diagnosis of Mycobacterium marinum infection.Methods:The data of suspected patients with M.marinum infection in out-patient treatment of our hospital were analyzed retrospectively.Exclusion of tuberculosis,the patients were divided into M.marinum infection group and control group(fungal and other bacterial infections)according to the qPCR result.TB.IGRA was used to detect tuberculosis infection-specific T cells of patients peripheral blood.The sensitivity,specificity,predictive value and likelihood ratio between TB.IGRA and acid-fast staining in the diagnosis of M.marinum infection were compared and analyzed.We further discussed the sensitivity,specificity of TB.IGRA andγ-Interferon level of patients with M.marinum infection in different age groups.Results:A total of 87 patients with M.marinum infection and 25 controls were enrolled.The sensitivity and specificity of TB.IGRA assay were 73.56%and 64.0%,respectively.The positive and negative predictive value and likelihood ratio were 87.7%,41.0%,2.04 and 0.41,respectively.The sensitivity of young group,middle-aged group and old group were 70.0%,73.5%and 74.4%,respectively.The specificity was highest in the middle-aged group(88.9%)and lowest in the elderly group(46.2%).Conclusion:TB.IGRA has important application value in the diagnosis and differential diagnosis of M.marinum infection.

关 键 词：结核感染T细胞γ-干扰素释放实验 海分枝杆菌感染 非结核分枝杆菌 

分 类 号：R52[医药卫生—内科学]