结核γ-干扰素释放分析试验联合胸腹水ADA检测在结核病诊断中的应用研究

Application of Tuberculosis Interferon γ-release Assay combined with Hydrothorax and Ascites ADA Detection in the Diagnosis of Tuberculosis

目的:探讨结核γ-干扰素(IFN-γ)释放分析试验联合胸腹水腺苷脱氨酶(ADA)检测在结核病诊断中的应用价值。方法:以2016年12月至2017年2月我院收治的150例疑似结核病患者及同期在我院体检的30例健康志愿者(记为健康组)为对象,依据经皮穿刺活检等结果分为结核组、非结核组,纳入患者均行结核IFN-γ释放分析试验,采集研究对象胸腹水样本,均行胸腹水ADA检测,比较三组IFN-γ释放分析试验结果、胸腹水ADA水平,同时分析IFN-γ释放分析试验、胸腹水ADA检测以及两者联合应用在结核病中的诊断效能。结果:结核组IFN-γ释放分析试验阳性例数、胸腹水ADA水平、IFN-γ释放分析试验阳性率、胸腹水ADA阳性率明显高于非结核组、健康组(P<0.05),而非结核组与健康组上述指标相较无明显差异(P>0.05); IFN-γ释放分析试验联合胸腹水ADA检测对结核病的诊断效能较两者单一检测时明显高。结论:联合结核IFN-γ释放分析试验及检测胸腹水ADA水平可有效提高结核病临床诊断效能,适于临床推广应用。

Objective：To investigate the value of tuberculosis interferon γ （IFN-γ） release assay combined with hydrothorax and ascites adenosine deaminase （ADA） detection in the diagnosis of tuberculosis.Methods： A total of 150 patients with suspected tuberculosis treated in our hospital during the period from December 2016 to February 2017 and 30 healthy volunteers （healthy group） who received physical examinationin our hospital during the same period were enrolled in this study. They were divided into the tuberculosisgroup and the non-tuberculosis group according to the results of percutaneous biopsy. All patients underwenttuberculosis IFN-γ release assay, and samples of hydrothorax and ascites was collected for ADA detection.Results： The positive rate of IFN-gamma release assay, ADA level in pleural and ascites, IFN-gamma release assay and ADA positive rate in pleural and ascites in tuberculosis group were significantly higher thanthose in non-tuberculosis group and healthy group （P〈0.05）, but there was no significant difference betweennon-tuberculosis group and healthy group （ P 〉 0. 05）. IFN-gamma release assay combined with ADA inpleural and ascites was more effective in the diagnosis of tuberculosis than the single test. Conclusion： Thecombination of tuberculosis IFN-gamma release assay and detection of ADA level in pleural and ascites can effectively improve the clinical diagnosis of tuberculosis. It is suitable for clinical popularization and application.