TB-IGRA与TST检测菌培阳性肺结核患者比较

Diagnostic applications of TB-IGRA and TST in patients with culture-positive tuberculosis

目的比较结核分枝杆菌γ-干扰素体外释放试验(TB-IGRA)与结核菌素皮肤试验(TST)在临床上用于检测MTB感染者的应用价值。方法 TB-IGRA与TST平行检测对147例菌培阳性肺结核患者,并分析年龄、性别和是否接种卡介苗对各自检测性能的影响。TST分别比较红肿硬块直径≥5mm(TST5)和≥15mm(TST15)者。结果 TB-IGRA和TST5的检出率分别为80.3%(118/147)和78.2%(115/147),均显著高于TST15的44.2%(65/147)。TB-IGRA在60岁以下年龄组的检出率显著高于60岁以上年龄组,TST15检出率随年龄变化趋势与TB-IGRA类似。是否接种卡介苗对TB-IGRA和TST15没有明显影响,而TST5在接种过卡介苗的患者中的阳性率显著高于未接种组。结论 TB-IGRA比TST有更高的检测灵敏度,可以作为判断结核分枝杆菌感染的手段之一。

The aim was to evaluate the clinical value on detecting Mycobacteriurn tuberculosis （MTB） of interferon-gam- ma release assay （TB-IGRA） comparing with tuberculin skin test （TST）. Total of 147 cases of culture-positive tuberculosis pa- tients were parallelly detected with TB-IGRA and TST, and the influence on their performance of age, sex and BCG vaccination were analyzed. TST was evaluated with two different criteria, diameter of swelling lumps ≥ 5mm （TSTs） and ≥ 15mm （TSTla） respectively. Results indicated that the positive rates of TB-IGRA and TST5 were 80. 30% （118/147） and 78. 20% （115/147） respectively, and significantly higher than 44.2G of TST1s （65/147）. The positive rate of TB-IGRA in patients be- low 60-year-old was significantly higher than those above 60-year-old, and that was observed in the results of TSTls. Vaccina- tion of BCG had no influence on the preformation of TB-IGRA and TST15, but the positive rate of TST5 was significantly higher in vaccinated group than in non-vaccinated group. In conclusion,TB-IGRA has higher sensitivity than TST, and could be used as one of the means to detect the MTB infection.