γ-干扰素释放试验在儿童肺结核中的诊断价值  

Diagnostic value of interferon-γ release assay in children with pulmonary tuberculosis

作　　者：李金沛 叶涛生[1] 张洁云[1] 张明霞[1] 杨倩婷[1] LI Jin-pei;YE Tao-sheng;ZHANG Jie-yun;ZHANG Ming-xia;YANG Qian-ting(Shenzhen Third People's Hospital,Shenzhen,Guangdong 518112,China)

机构地区：[1]深圳市第三人民医院,广东深圳518112

出　　处：《中国热带医学》2022年第4期388-390,共3页China Tropical Medicine

基　　金：深圳市科技计划项目(No.JCYJ20180228162336873)。

摘　　要：目的 探讨γ-干扰素释放试验(interferon-γ release assay,IGRA)在儿童肺结核中的检测效果,评价其用于儿童结核的诊断价值。方法 选取深圳市第三人民医院儿童肺结核患者507例为儿童肺结核组、52例儿童非结核肺部疾病组和247例健康儿童对照组,采用IGRA方法,并比较三组IGRA的阳性率,评价IGRA在结核病诊断中的应用价值。结果 在健康儿童IGRA阳性率为21.05%(52/247),其中有结核病人接触史儿童IGRA阳性率为30.76%(16/52),无结核接触史儿童IGRA阳性率为18.46%(36/195),差异有统计学意义(χ^(2)=3.74,P<0.05);结核病患儿和肺炎患儿IGRA阳性率分别为72.39%(367/507)和17.31%(9/52),差异有统计学意义(χ^(2)=64.97,P<0.01);菌阳结核病患儿和菌阴结核病患儿IGRA阳性率分别为82.28%(209/254)和62.45%(158/253),差异有统计学意义(χ^(2)=24.94,P<0.01)。结论 IGRA对有结核病人接触史儿童IGRA阳性率较高,显示可用于诊断结核潜伏感染,且显示对菌阳结核病患儿也有较高的阳性率,也可用于儿童结核病诊断。IGRA可在儿童结核病中成为一种的辅助检查手段。ObjectiveTo study the diagnostic effect of interferon-γ release assay(IGRA) in children with pulmonary tuberculosis, to evaluate its diagnostic value in children with tuberculosis.MethodsTotally 507 cases of children with pulmonary tuberculosis, 77 cases of children with non tuberculosis pulmonary diseases and 247 cases of healthy children were enrolled in this study. The positive rates of IGRA in the three groups were compared, to evaluate the application value of IGRA in tuberculosis diagnosis.ResultsThe positive rate of IGRA in healthy children was 21.05%(52/247). The positive rate of IGRA in children with tuberculosis exposure history was 30.76%(16/52), and that in children without tuberculosis exposure history was 18.46%(36/195). The positive rate of IGRA was statistically significant between the two groups(χ^(2)=3.74, P=0.05).The positive rates of IGRA in children with tuberculosis and pneumonia were 72.39%(367/507)and 17.31%(9/52)respectively, and the difference was statistically significant(χ^(2)=64.97, P<0.01). The positive rates of IGRA in children with smear positive tuberculosis and in children with smear negative tuberculosis were 82.28%(209/254)and 62.45%(158/253)respectively, and the difference was statistically significant(χ^(2)=24.94, P<0.01).ConclusionsIGRA can be used to diagnose latent infection of tuberculosis, and is of great value to the diagnosis of tuberculosis in children. It can be used as an auxiliary examination method in children with tuberculosis.

关 键 词：肺结核 儿童 Γ-干扰素释放试验 结核潜伏感染 

分 类 号：R521.1[医药卫生—内科学]