营养不良对γ-干扰素释放试验检测结核病阳性率的影响  

Influence of malnutrition on positive rate of interferon gamma release assay (IGRA) in patients with tuberculosis

作　　者：拉巴 张蒙蒙[1] 王明桂 贺建清[1] LA Ba;ZHANG Meng-meng;WANG Ming-gui;HE Jian-qing(Department of Respiratory and Critical Care Medicine,West China Hospitalof Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,成都610041

出　　处：《中国防痨杂志》2022年第6期595-599,共5页Chinese Journal of Antituberculosis

基　　金：国家自然科学基金(81870015)。

摘　　要：目的:探讨营养不良是否影响γ-干扰素释放试验(IGRA)检测结核病的阳性率。方法:查阅电子病历纳入2015年1月至2018年11月于四川大学华西医院呼吸与危重症医学科符合入组标准的443例住院结核病患者,根据体质量指数(BMI)分为营养不良组(BMI<18.5;136例)和非营养不良组(BMI≥18.5;307例)。采用酶联免疫吸附法在体外测定患者新鲜肝素化全血在结核特异性抗原刺激后释放γ-干扰素的浓度,比较IGRA对两组患者的检测阳性率。结果:443例患者中,IGRA检测营养不良组的阳性率[76.47%(104/136)]与非营养不良组[78.18%(240/307)]的差异无统计学意义(χ^(2)=0.158,P=0.712)。在103例病原学确诊的结核病患者中,IGRA检测营养不良组的阳性率[75.61%(31/41)]与非营养不良组[80.65%(50/62)]的差异无统计学意义(χ^(2)=0.373,P=0.542)。结论:营养不良不会影响结核病患者IGRA检测的阳性率。Objective:To investigate whether malnutrition affects the positive rate ofγ-interferon release assay(IGRA)in patients with tuberculosis.Methods:From January 2015 to November 2018,443 patients with tuberculosis who were admitted to the Department of Respiratory and Critical Care Medicine,West China Hospital were included by reviewing electronic medical record.According to body mass index(BMI),they were divided into malnutrition group(BMI<18.5;136)and no-malnutrition group(BMI≥18.5;307).Enzyme linked immunosorbent assay was used to measure the concentration of interferon-γin fresh heparinized whole blood stimulated by tuberculosis specific antigen in vitro.The positive rate of IGRA in the two groups was compared.Results:A total of 443 patients,the positive rate of IGRA was 76.47%(104/136)in the malnourished group and 78.18%(240/307)in the no-malnutrition group,there was no significant difference between the two groups(χ^(2)=0.158,P=0.712).Among the bacterium-confirmed tuberculosis patients,the positive rate of IGRA was 75.61%(31/41)in the malnutrition group and 80.65%(50/62)in the no-malnutrition group,there was no significant difference between the two groups(χ^(2)=0.373,P=0.542).Conclusion:Malnutrition does not affect the positive rate of IGRA in patients with tuberculosis.

关 键 词：结核 干扰素Γ 免疫学试验 营养评价 对比研究 

分 类 号：R446.4[医药卫生—诊断学] R591[医药卫生—临床医学]