本文關(guān)鍵詞： 結(jié)核 PPD T淋巴細(xì)胞 γ-干擾素釋放試驗(yàn)　出處：《中華醫(yī)院感染學(xué)雜志》2017年18期 　論文類型：期刊論文

【摘要】：目的探討結(jié)核感染T淋巴細(xì)胞γ-干擾素釋放試驗(yàn)(TB-IGRAs)用于結(jié)核病診斷的研究。方法回顧性分析醫(yī)院2016年1-9月呼吸內(nèi)科收治的疑似結(jié)核病患者207例,收集疑似結(jié)核病患者的TB-IGRAs結(jié)果和臨床特征等資料;207例疑似結(jié)核病患者分為三組進(jìn)行研究,檢測(cè)卡介苗純蛋白衍生物試驗(yàn)(PPD)陽(yáng)性加做TBIGRAs為PPD陽(yáng)性檢測(cè)組75例;檢測(cè)PPD陰性加做TB-IGRAs為PPD陰性檢測(cè)組50例;直接檢測(cè)TB-IGRAs為直接檢測(cè)組82例;對(duì)三組研究病例TB-IGRAs的結(jié)果進(jìn)行比較分析。結(jié)果 207例疑似結(jié)核患者,131例出院診斷為結(jié)核病,PPD陽(yáng)性檢測(cè)組TB-IGRAs檢測(cè)陽(yáng)性率為76.20%,高于PPD陰性檢測(cè)組50%(P0.05);PPD陽(yáng)性檢測(cè)組高于直接檢測(cè)組75%,但差異無(wú)統(tǒng)計(jì)學(xué)意義;直接檢測(cè)組高于PPD試驗(yàn)陰性檢測(cè)組(P0.05);與PPD陽(yáng)性檢測(cè)組比較,直接檢測(cè)組檢測(cè)陽(yáng)性率比較差異無(wú)統(tǒng)計(jì)學(xué)意義;與PPD陰性檢測(cè)組比較,PPD試驗(yàn)陽(yáng)性檢測(cè)組、直接檢測(cè)組陽(yáng)性率比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);PPD陽(yáng)性檢測(cè)組TB-IGRAs檢測(cè)靈敏度為94.10%,特異性為37.50%,AUC為0.67;直接檢測(cè)組TB-IGRAs檢測(cè)靈敏度為66.70%,特異性為73.00%,AUC為0.74。結(jié)論 PPD試驗(yàn)陽(yáng)性加做TB-IGRAs可提高結(jié)核病的檢測(cè)靈敏度;PPD試驗(yàn)陽(yáng)性加做TBIGRAs在結(jié)核病的陽(yáng)性分布與患者直接檢測(cè)TB-IGRAs無(wú)區(qū)別;ROC曲線顯示TB-IGRAs在結(jié)核病中診斷效率低。
[Abstract]:Objective to investigate the release of interferon 緯 (IFN 緯) from T lymphocytes infected with tuberculosis (TB-IGRAs). Methods 207 suspected tuberculosis patients admitted to Department of Respiratory Medicine from 2016 to September in our hospital were analyzed retrospectively. TB-IGRAs results and clinical features of suspected tuberculosis patients were collected. 207 suspected tuberculosis patients were divided into three groups. 75 cases were positive for BCG pure protein derivative test and 75 cases for PPD positive test. There were 50 cases of PPD negative test group with PPD negative and TB-IGRAs; TB-IGRAs was detected directly in 82 cases in the group of direct detection. The results of TB-IGRAs in three study groups were compared and analyzed. Results #number0# patients with suspected tuberculosis were discharged from hospital and diagnosed as tuberculosis. The positive rate of TB-IGRAs in PPD positive group was 76.20, which was higher than that in PPD negative test group (P 0.05). The PPD positive group was higher than that of the direct test group (75%), but the difference was not statistically significant. The direct test group was higher than the PPD test negative group (P 0.05). There was no significant difference in positive rate between direct test group and PPD positive group. The positive rate of direct test group was significantly higher than that of PPD negative group (P 0.05). In PPD positive group, the sensitivity of TB-IGRAs was 94.10 and the specificity was 37.50. AUC was 0.67; The sensitivity of TB-IGRAs in the direct detection group was 66. 70 and the specificity was 73.00%. AUC was 0.74. Conclusion positive PPD test plus TB-IGRAs can improve the sensitivity of tuberculosis detection. There was no difference between the positive distribution of PPD test plus TBIGRAs in tuberculosis and the direct detection of TB-IGRAs in patients. ROC curve showed that TB-IGRAs was less effective in diagnosis of tuberculosis.
【作者單位】： 紹興市立醫(yī)院檢驗(yàn)科;
【基金】：紹興市衛(wèi)生計(jì)生委成果轉(zhuǎn)化項(xiàng)目(2016ZH003)
【分類號(hào)】：R446.6;R52
【正文快照】： 目前多個(gè)國(guó)家已將結(jié)核感染T淋巴細(xì)胞γ-干擾素釋放試驗(yàn)(TB-IGRAs)用于診斷結(jié)核潛伏期感染(LTBI),我國(guó)部分三級(jí)甲等�？漆t(yī)院已常規(guī)開(kāi)展此項(xiàng)檢測(cè),多家TB-IGRAs試劑已經(jīng)或即將進(jìn)入臨床應(yīng)用。我國(guó)是結(jié)核病高發(fā)國(guó)家之一,2010年全國(guó)抽樣調(diào)查結(jié)果顯示,全國(guó)≥15歲人口中活動(dòng)性肺結(jié)核患

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