重组结核杆菌融合蛋白在大学生结核潜伏感染筛查中的应用分析  

Analysis of recombinant mycobacterium tuberculosis fusion protein in screening for latent tuberculosis infection in college students

作　　者：杨震[1] 孙倩[1] 韩露[1] 包城 王雪 张治国[1] Yang Zhen;Sun Qian;Han Lu;Bao Cheng;Wang Xue;Zhang Zhiguo(Beijing Changping Institute for Tuberculosis Prevention and Treatment,Beijing 102202,China)

机构地区：[1]北京市昌平区结核病防治所,北京102202

出　　处：《中国医学前沿杂志（电子版）》2022年第7期51-54,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家科技重大专项(20182X10103001);首都卫生发展科研专项(首发2022-1G-2161)。

摘　　要：目的通过分析重组结核杆菌融合蛋白(recombinant mycobacterium tuberculosis fusion protein,EC)皮肤试验和γ干扰素释放试验(interferon-gamma release assay,IGRA)结果,探讨EC皮肤试验在筛查学生结核杆菌感染中的实用性,为进一步做好学校结核病疫情控制提供建议。方法选取1924例同学的IGRA和EC皮肤试验结果进行分析,检验结果一致性采用Kappa检验,采用配对χ2检验两组检测方法之间的差异,以P<0.05为差异有统计学意义。结果共纳入1924例研究对象,其中男生1274例,女生650例;IGRA阳性率5.35%;EC皮肤试验阳性率9.10%,不同检测方法阳性率之间差异具有统计学意义(配对χ^(2)=37.57,P<0.01),Kappa值为0.47,两种检测方法检测结果为中度一致性。以γ干扰素检测作为结核感染的金标准,EC皮肤试验的敏感度为67.96%、特异度为94.23%、阳性预测值为40.00%、阴性预测值为98.11%。结论EC皮肤试验具有较强的特异性,可用于大学生结核病筛查。Objective To explore the feasibility of recombinant mycobacterium tuberculosis fusion protein(EC)skin test in screening tuberculosis infection by comparison between EC skin test and interferon-gamma release assay(IGRA),and to provide suggestions for further improvement of tuberculosis epidemic control in schools.Method Both IGRA and EC skin test were performed in 1924 students.Kappa test was used to test the consistency of the results,and Mc Nemar’s test was used to compare the difference between the two testing methods,and the P value<0.05 was considered as be significant difference.Result A total of 1924 subjects were enrolled(1274 males and 650 females).The proportion of positive IGRA and EC skin test were 5.35%,and 9.10%,respectively,with significant difference(χ^(2)=37.57,P<0.01).The kappa value was 0.47.The two methods were moderately consistent.Compared with IGRA as the gold standard for tuberculosis infection,the sensitivity,specificity,positive predictive value and negative predictive value of EC were 67.96%,94.23%,40.00%and 98.11%,respectively.Conclusion EC has favorable specificity and is practical for tuberculosis screening among college students.

关 键 词：结核杆菌感染 结核感染 Kappa检验 皮肤试验 KAPPA值 不同检测方法 TUBERCULOSIS 结核潜伏感染 

分 类 号：R52[医药卫生—内科学]