化学发光法干扰素-γ释放试验在肺结核辅助诊断中的价值  

Role of chemiluminescence interferon gamma release assay in auxiliary diagnosis of pulmonary tuberculosis

作　　者：盖林林 李海波[1] 褚锦锦 孙家梅 闫心怡 杜金珂 代文清 徐栋花 GAI Linlin;LI Haibo;CHU Jinjin;SUN Jiamei;YAN Xinyi;DU Jinke;DAI Wenqing;XU Donghua(Central Laboratory,Weifang People's Hospital,Weifang 261000,Shandong,China)

机构地区：[1]潍坊市人民医院中心实验室,山东潍坊261000

出　　处：《检验医学》2023年第3期257-260,共4页Laboratory Medicine

基　　金：山东省自然科学基金项目(ZR2020KC001);潍坊市卫生健康委科研项目(WFWSJK-2021-014);潍坊市科技局基金项目(2020YX084)。

摘　　要：目的探讨化学发光法干扰素-γ释放试验在肺结核辅助诊断中的临床应用价值。方法选取2019年3月1日—2020年12月31日潍坊市人民医院183例肺结核患者和33名健康体检者(对照组);将183例肺结核患者分为活动性肺结核组(109例)和非活动性肺结核组(74例)。对所有研究对象行化学发光干扰素-γ释放试验、结核菌素皮内试验、T-SPOT TB试验和血常规检测,比较不同方法诊断肺结核的效能和活动性肺结核组干扰素-γ释放试验阳性、阴性患者血常规检测结果的差异。结果活动性肺结核组、非活动性肺结核组、对照组化学发光干扰素-γ释放试验阳性率分别为92.66%、62.16%、9.09%,3个组阳性率差异有统计学意义(P<0.05)。干扰素-γ释放试验和结核菌素皮内试验、T-SPOT TB和结核菌素皮内试验诊断肺结核的敏感性差异有统计学意义(P<0.05),特异性、阳性预测值、阴性预测值差异均无统计学意义(P>0.05)。干扰素-γ释放试验诊断肺结核的敏感性、特异性、阳性预测值和阴性预测值均稍高于T-SPOT TB试验,但差异均无统计学意义(P>0.05)。活动性肺结核组干扰素-γ释放试验阳性、阴性患者外周血白细胞计数、淋巴细胞绝对值、淋巴细胞百分比差异均无统计学意义(P>0.05)。结论化学发光法干扰素-γ释放试验方便、快捷,对辅助诊断肺结核有一定的价值。Objective To investigate the clinical application value of chemiluminescence interferon gamma release assay in the auxiliary diagnosis of pulmonary tuberculosis.Methods Totally,183 pulmonary tuberculosis patients and 33 healthy subjects in Weifang People's Hospital from March 1,2019 to December 31,2020 were enrolled.They were classified into active pulmonary tuberculosis group(109 cases)and inactive pulmonary tuberculosis group(74 cases).The performance of chemiluminescence interferon gamma release assay,tuberculin skin allergy test,T-SPOT TB test and blood routine test were evaluated.The difference of blood routine test positive and negative results in chemiluminescence interferon gamma release assay for active pulmonary tuberculosis group was compared.Results The positive rates of active pulmonary tuberculosis group,inactive pulmonary tuberculosis group and healthy control group were 92.66%,62.16%and 9.09%by chemiluminescence interferon gamma release assay,respectively(P<0.05).The sensitivities of chemiluminescence interferon gamma release assay,tuberculin skin allergy test and T-SPOT TB test had statistical significance(P<0.05),and the specificities,positive predictive values and negative predictive values had no statistical significance(P>0.05).The sensitivity,specificity,positive predictive value and negative predictive value of chemiluminescence interferon gamma release assay were slightly higher than those of T-SPOT TB test(P>0.05).There was no statistical significance in the absolute value of white blood cell,the absolute value of lymphocyte and the percentage of lymphocyte in peripheral blood between chemiluminescence interferon gamma release assay positive and negative patients in active pulmonary tuberculosis group(P>0.05).Conclusions Chemiluminescence interferon gamma release assay is convenient and rapid and has certain guiding significance for the auxiliary diagnosis of pulmonary tuberculosis.

关 键 词：干扰素-γ释放试验 化学发光法 肺结核 

分 类 号：R446.61[医药卫生—诊断学]