全血γ-干扰素释放试验对活动性结核病的辅助诊断价值

Values of Whole Blood Interferon-γ Release Test in Active Tuberculosis's Auxiliary Diagnosis

目的研究全血γ-干扰素(interferon gamma,IFN-γ)释放试验对活动性结核病的辅助诊断价值。方法应用化学发光酶免疫分析法分别检测124例结核病患者、60例非结核肺部疾病患者、33名健康对照者全血中IFN-γ水平;绘制受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)确定其诊断活动性结核病的临界值,并评价其对活动性结核病的诊断效能。结果活动性结核病患者组结核特异性IFN-γ的水平为405±306pg/mL,显著高于非结核肺部疾病组(111±127pg/mL,P<0.001)和健康对照组(52.20±28.28pg/mL,P<0.001)。而健康对照组与非结核肺部疾病组差异无统计学意义(P>0.05)。结核特异性IFN-γ诊断结核病的临界值为143pg/mL,其灵敏度和特异性分别为86.3%和77.8%。结论全血γ-干扰素释放试验可能成为活动性结核病辅助诊断指标之一。

Objective To explore the value of interferon-γ（IFN-γ）release test in active tuberculosis＇s auxiliary diagnosis Methods The whole blood levels of IFN-γ in 124 cases of tuberculosis patients,60 patients with non-tuberculous pulmonary diseases and 33 healthy controls were detected by Chemiluminescence enzyme immunoassay method.The receiver operating characteristic curve was drawn to determine the threshold of IFN-γ for diagnosis of active tuberculosis and to evaluate its diagnostic performance.Results The specific IFN-γ level in active tuberculosis group（405 ± 306 pg/mL） was significantly higher than that of non-tuberculous pulmonary disease group（111±127 pg/mL,P0.001） and healthy control group（52.20±28.28 pg/mL,P0.001）,but the healthy control group and non-tuberculous respiratory disease group had no statistically significant difference（P0.05）.The threshold of IFN-γ for diagnosis of tuberculosis was 143pg/mL and its sensitivity and specificity were 86.3% and 77.8% respectively.Conclusion The whole blood interferon-γ release test may be regarded as one of index in auxiliary diagnosis of active tuberculosis.