γ干扰素释放试验在儿童结核病和潜伏结核感染中的诊断价值

The diagnostic significance of interferon-gamma release assays in children with active tuberculosis and latent tuberculosis infection

目前全球儿童结核病疫情形势严峻，诊断仍然依赖传统的检测方法。结核菌素皮肤试验对于卡介苗接种及非结核分枝杆菌感染不易鉴别。γ干扰素释放试验在国内已逐步推广，对儿童结核病的诊断有较高的敏感度和特异度。在潜伏结核感染的儿童中，结合暴露分级评价，γ干扰素释放试验特异度更高，结核菌素皮肤试验敏感度更高。使用IGRA开展人群大规模筛查并不现实，但是针对性选择高危人群进行检测确有必要。在儿童结核病诊疗领域，应当将IGRA与TST结合起来，取长补短，结合实际情况进行分析。

At present, the global situation of tuberculosis in children remains serious. The process of diagno- sis still relies on the traditional methods. The results of tuberculin skin test （TST） can not easily identify BCG vac- cination and infection with non-tuberculous mycobacteriuum Interferon-gamma release assays （IGRA） have been popularized in China, and have a relatively high sensitivity and specificity for the diagnosis of tuberculosis in chil- dren. In children with latent tuberculosis infection （LTBI）, referring to the exposure classification, the specificity of interferon-gamma release assays is higher and the sensitivity of tuberculin skin test is better. Screening for latent in- fection in a very large general population with IGRA is clearly unrealistic, but it is necessary for those at a higher risk of tuberculosis development. Clinical manifestation, IGRA and TST should be combined to analysis for the diagnosis of tuberculosis in children.