QuantiFERON-TB Gold Plus与QuantiFERON-TB Gold In-Tube在骨关节结核辅助诊断中的比较研究  

Comparison of QuantiFERON-TB Gold Plus with QuantiFERON-TB Gold In-Tube assay in auxiliary diagnosis of osteoarticular tuberculosis

作　　者：贾红彦[1] 范俊[1] 孙琦[1] 宋瑞雪 杜博平 董静 王颖超 邢爱英[1] 朱传智 李自慧[1] 潘丽萍[1] Jia Hongyan;Fan Jun;Sun Qi;Song Ruixue;Du Boping;Dong Jing;Wang Yingchao;Xing Aiying;Zhu Chuanzhi;Li Zihui;Pan Liping(Beijing Key Laboratory for Drug Resistant Tuberculosis Research,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China)

机构地区：[1]耐药结核病研究北京市重点实验室/首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所,北京101149

出　　处：《中国防痨杂志》2024年第6期648-653,共6页Chinese Journal of Antituberculosis

基　　金：北京市自然科学基金(L234055);通州区科技计划项目(KJ2022CX042);北京市医院管理中心青年职工创新工作室-创新梦工场(202136);通州区运河计划人才项目(YH202001)。

摘　　要：目的:评价QuantiFERON-TB Gold Plus(简称“QFT-Plus”)和QuantiFERON-TB Gold In-Tube(简称“QFT-GIT”)检测辅助诊断骨关节结核的应用价值及其检测结果的一致性。方法:选取2023年4—9月于首都医科大学附属北京胸科医院就诊的骨关节结核患者88例作为观察组,非结核性骨关节疾病患者123例作为对照组。所有研究对象同时行外周血QFT-Plus和QFT-GIT检测。分析QFT-Plus和QFT-GIT辅助诊断骨关节结核的价值,评价两种方法检测结果的一致性。结果:211例研究对象中,剔除4例检测为不确定结果者,最终将207例研究对象检测结果纳入诊断性能评估(观察组86例,对照组121例)。QFT-Plus检测的敏感度为95.3%(95%CI:87.9%~98.5%),特异度为70.2%(95%CI:61.2%~78.0%),阳性预测值为65.5%(95%CI:60.2%~77.5%),阴性预测值为95.5%(95%CI:88.3%~98.6%);QFT-GIT检测的敏感度为91.9%(95%CI:83.4%~96.4%),特异度为66.9%(95%CI:57.7%~75.1%),阳性预测值为66.4%(95%CI:57.1%~74.6%),阴性预测值为92.0%(95%CI:83.8%~96.5%)。QFT-Plus和QFT-GIT检测结果的总一致率为91.8%(95%CI:88.1%~95.5%),阳性一致率为92.4%(95%CI:87.7%~97.2%),阴性一致率为90.9%(95%CI:84.9%~96.9%),一致性检验Kappa值为0.832(95%CI:0.756~0.908,P<0.001)。结论:QFT-Plus与QFT-GIT检测结果具有良好的一致性,在骨关节结核诊断中具有相似的辅助诊断效能。Objective:To assess the utility and concordance of QuantiFERON-TB Gold Plus(QFT-Plus)and QuantiFERON-TB Gold In-Tube(QFT-GIT)assays in the adjunctive diagnosis of osteoarticular tuberculosis.Methods:Between April and September 2023,88 patients diagnosed with osteoarticular tuberculosis at the Beijing Chest Hospital,affiliated with Capital Medical University,were enrolled as the observation group,while 123 individuals presenting with non-tuberculous osteoarticular conditions comprised the control group.Each participant underwent concurrent peripheral blood assays using both the QFT-Plus and QFT-GIT.This study evaluated the diagnostic utility and result concordance of the two tests in aiding the diagnosis of osteoarticular tuberculosis.Results:Of the 211 initial participants,4 were excluded due to indeterminate results,leaving 207 subjects for analysis(86 in the observation group and 121 in the control).The QFT-Plus assay demonstrated a sensitivity of 95.3%(95%CI:87.9%-98.5%),specificity of 70.2%(95%CI:61.2%-78.0%),positive predictive value of 65.5%(95%CI:60.2%-77.5%),and negative predictive value of 95.5%(95%CI:88.3%-98.6%).The QFT-GIT assay recorded a sensitivity of 91.9%(95%CI:83.4%-96.4%),specificity of 66.9%(95%CI:57.7%-75.1%),positive predictive value of 66.4%(95%CI:57.1%-74.6%),and negative predictive value of 92.0%(95%CI:83.8%-96.5%).The overall concordance between QFT-Plus and QFT-GIT results was 91.8%(95%CI:88.1%-95.5%),with a positive agreement of 92.4%(95%CI:87.7%-97.2%)and a negative agreement of 90.9%(95%CI:84.9%-96.9%).The Kappa coefficient for agreement was 0.832(95%CI:0.756-0.908,P<0.001).Conclusion:The QFT-Plus and QFT-GIT assays demonstrated substantial concordance and comparable diagnostic efficacy in the auxiliary evaluation of osteoarticular tuberculosis.

关 键 词：结核 骨关节 诊断 鉴别 免疫学试验 评价研究 

分 类 号：R529.2[医药卫生—内科学]