外周血IGRA阴性活动性结核患者免疫指标分析  

作　　者：吴辉飞 余旭良 潘清波 黄炜晔 祝进 陆军 

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院),324000

出　　处：《浙江临床医学》2024年第8期1192-1194,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探究外周血γ干扰素释放试验(IGRA)阴性的活动性结核患者免疫学特征。方法回顾性分析2019年2月至2022年2月诊断明确的579例活动性肺结核患者临床资料,分为IGRA阴性结核组(70例)和IGRA检测阳性结核组(509例)。收集患者一般情况、血清生化指标、血常规指标、外周血淋巴细胞亚群指标,比较组间中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)等免疫相关指标。结果两组患者年龄、NLR、PLR、总蛋白、淋巴细胞计数、红细胞计数、CD3^(+)CD4^(+)细胞计数、淋巴细胞计数流式比较,差异有统计学意义(P<0.05)。结论需警惕老年患者以及患者外周CD3^(+)CD4^(+)细胞计数减少,NLR>7.16、PLR>343.91的活动性结核患者T细胞检查易出现假阴性,建议优先考虑其他结核相关检测。Objective To investigate the immunological characteristics of active tuberculosis patients those interferon gamma release tests(IGRA)were negative.Methods A total of 579 patients with active pulmonary tuberculosis from February 2019 to February 2022 were retrospectively analyzed,They were divided into IGRA negative tuberculosis group(70 cases)and IGRA positive tuberculosis group(509 cases).Their general conditions,serum biochemical parameters,routine blood tests,and peripheral blood lymphocyte were collected and compared between groups for derived immune-related parameters such as NLR and PLR.Results Comparison of age,NLR,PLR,total protein,lymphocyte count,erythrocyte count,CD3^(+)CD4^(+)cell count,and lymphocyte count flow between the two groups of patients was statistically significant(P<0.05).Conclusion It is necessary to be alert to false negative T cell examination in active tuberculosis patients with reduced peripheral CD3^(+)CD4^(+)cell count,older age,NLR greater than 7.16,PLR greater than 343.91.

关 键 词：活动性结核 Γ干扰素释放试验 免疫指标 

分 类 号：R52[医药卫生—内科学]