肺泡灌洗液γ-干扰素释放试验在肺结核诊断中的价值及其影响因素的分析  

Value of bronchoalveolar lavage interferon-γrelease assay for diagnosis of pulmonary tuberculosis and the risk factors of false negative results

作　　者：李晓倩 梁亚充 王玉红[1] 董雅坤[1] 谢兰品[1] 王智慧[1] 池跃朋[1] LI Xiao-qian;LIANG Ya-chong;WANG Yu-hong;DONG Ya-kun;XIE Lan-pin;WANG Zhi-hui;CHI Yue-peng(The Second Tuberculosis Department,Hebei Chest Hospital,Shijiazhuang,Hebei 050041,China)

机构地区：[1]河北省胸科医院结核二科,河北石家庄050041

出　　处：《临床肺科杂志》2023年第4期487-493,共7页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究重点课题(No.20200027)。

摘　　要：目的探讨肺泡灌洗液γ-干扰素释放试验,在肺结核诊断中的价值及其假阴性影响因素的分析。方法回顾性收集2019年1月—2021年1月于河北省胸科医院就诊的活动性肺结核患者205例,非结核患者106例为研究对象,探讨肺泡灌洗液γ-干扰素释放试验,对肺结核的诊断价值;分析肺泡灌洗液γ-干扰素释放试验假阴性的可能影响因素。结果肺泡灌洗液-γ干扰素释放试验,在肺结核诊断中的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为:85.9%(176/205)、77.4%(82/106)、88%(176/200)、73.9%(82/111)、83%(258/311)。对可能影响肺泡灌洗液-γ干扰素释放试验的因素进行Logistic分析,发现白细胞计数、中性粒细胞百分比、血沉升高及淋巴细胞百分比降低是肺结核患者灌洗液γ-干扰素释放试验假阴性的独立危险因素。结论肺泡灌洗液γ-干扰素释放试验,在活动性肺结核诊断中具有较高的诊断效能。白细胞计数、中性粒细胞百分比、血沉升高及淋巴细胞百分比降低是肺结核患者灌洗液γ-干扰素释放试验假阴性的独立危险因素。Objective To investigate the value of bronchoalveolar lavage interferon-γrelease assay in the diagnosis of pulmonary tuberculosis and analyze the risk factors of false negative results.Methods The clinical data of 205 patients with active pulmonary tuberculosis from January 2019 to January 2021 in Hebei Chest Hospital were retrospectively analyzed,and another 106 non-pulmonary tuberculosis people were taken as the control group.The value of bronchoalveolar lavage interferon-γrelease assay in the diagnosis of pulmonary tuberculosis was explored,and the risk factors associated with false negative results were investigated.Results The sensitivity,specificity,positive predictive value and negative predictive value of bronchoalveolar lavage interferon-γrelease assay in the diagnosis of pulmonary tuberculosis were respectively 85.9%(176/205),77.4%(82/106),88%(176/200),73.9%(82/111),and 83%(258/311)respectively.By analyzing the factors that might lead to false negative results of bronchoalveolar lavage interferon-γrelease assay,it found that increase of white blood,neutrophilic granulocyte percentage,erythrocyte,as well as procalcitonin were dependent factors for false negative results of bronchoalveolar lavage interferon-γrelease assay.Conclusion The bronchoalveolar lavage interferon-γrelease assay has high diagnostic efficacy for active tuberculosis.The increase of white blood,neutrophilic granulocyte percentage,erythrocyte as well as procalcitonin are dependent factors for false negative results of bronchoalveolar lavage interferon-γrelease assay.

关 键 词：结核 肺 Γ-干扰素 肺泡灌洗液 全血 假阴性 危险因素 

分 类 号：R521[医药卫生—内科学]