TB-IGRA在结核病诊断中的临床应用价值  

Clinical application value of TB-IGRA in the diagnosis of tuberculosis

作　　者：梁焕喜 黎敬忠 郭键瑜 黄蕴怡 李叶文 苏美玲 郭炽星 LIANG Huanxi;LI Jingzhong;GUO Jianyu;HUANG Yunyi;LI Yewen;SU Meiling;GUO Chixing(Chronic Disease Prevention and Control Station of Panyu District,Guangzhou,Guangdong 511400,China)

机构地区：[1]广州市番禺区慢性病防治站,广东广州511400

出　　处：《国际检验医学杂志》2024年第S02期72-75,共4页International Journal of Laboratory Medicine

摘　　要：目的评价γ干扰素释放分析实验(IGRA)技术在结核分枝杆菌感染的辅助诊断中的临床应用价值。方法收集2021-2022年在该站门诊就诊的疑似结核病的临床样本,采用TB-IGRA法检测结核分枝杆菌特异度抗原刺激血液样本中致敏T细胞分泌的γ干扰素含量,同时对患者的痰液样本做抗酸菌痰涂片镜检以及痰固体培养法来辅助诊断结核分枝杆菌的感染情况。结果在对收集的1688份临床样本的检测发现,TB-IGRA总阳性率为68.48%,抗酸菌涂片镜检的阳性率为14.28%,痰培养的阳性率为28.67%,TB-IGRA阳性率最高,痰涂片镜检法最低,相互之间比较,差异有统计学意义(P<0.01)。特别是对临床确诊为结核病的102份样本进行分析,TB-IGRA的检出率(78.43%)显著高于抗酸染色法(40.20%)和固体培养法(49.02%),TB-IGRA与固体培养法比较,χ^(2)=18,P<0.01;TB-IGRA与抗酸染色法比较,χ^(2)=24.89,P<0.01,均具有统计学意义。结论TB-IGRA比痰固体培养法、痰涂片抗酸染色法有更高的检出率和灵敏度,对结核病的早期诊断,特别是对潜伏感染、菌阴肺结核以及肺外结核的辅助鉴别诊断,具有重要的临床参考意义。Objective To evaluate the clinical application value of interferon-gamma release assay(IGRA)technology in the auxiliary diagnosis of tuberculosis.Methods Clinical samples of suspected tuberculosis from 2021-2022 were collected from the clinic of the station,and the content of interferon gamma secreted by sensi-tized T cells in blood samples stimulated by specific antigen of Mycobacterium tuberculosis was detected by TB-IGRA method.At the same time,acid fast sputum smear microscopy and sputum solid culture method were performed on sputum samples of patients to help diagnose the infection of Mycobacterium tuberculosis.Results Among the 1688 clinical samples,the total positive rate of TB-IGRA was 68.48%,the positive rate of acid-fast staining was 14.28%,and the positive rate of sputum culture was 28.67%.The TB-IGRA positive rate was the highest,and the acid-fast staining method was the lowest,with significant differences between the two methods(P<0.01).Especially for 102 samples clinically diagnosed as tuberculosis,the detection rate of TB-IGRA(78.43%)was significantly higher than that of acid fast staining(40.20%)and solid culture(49.02%).Comparison between TB-IGRA and solid culture method,with a chi square of 18 and P<0.01;The comparison between TB-IGRA and acid fast staining method showed a chi square value of 24.89,P<0.01,both of which were statistically significant.The difference between TB-IGRA and solid culture method was statistically significant(χ^(2)=18.00,P<0.01),and the difference between TB-IGRA and acid fast stai-ning method is statistically significant(χ^(2)=24.89,P<0.01).Conclusion TB-IGRA has higher detection rate and sensitivity than sputum solid culture method and sputum smear acid fast staining method.It has impor-tant clinical reference significance for the early diagnosis of tuberculosis,especially for the auxiliary differential diagnosis of latent infection,bacteria negative pulmonary tuberculosis and extrapulmonary tuberculosis.

关 键 词：结核病 结核分枝杆菌 TB-IGRA 诊断 

分 类 号：R52[医药卫生—内科学] R446[医药卫生—临床医学]