γ-干扰素释放试验在结核病诊断中的临床价值

Clinical value of γ-interferon release test in the diagnosis of tuberculosis

目的评价γ-干扰素释放酶联免疫试验（TB-IGRA）在结核病诊断中的临床价值。方法收集2014年9月-2015年8月在本院就诊的患者临床资料,结核病组193例（其中肺内结核144例、肺外结核49例）,非结核病组78例,分别采用TB-IGRA试验、结核抗体金标法、痰涂片法等方法检测结核分枝杆菌感染,并进行统计学分析评价。结果肺内结核和肺外结核TB-IGRA的检测阳性率均明显高于结核抗体、痰涂片检测的结果,差异有统计学意义（P〈0.05）;肺内结核TB-IGRA检测阳性率（93.06%）与肺外结核TB-IGRA检测阳性率（91.84%）比较,差异无统计学意义（χ^2=0.081,P〉0.05）;结核病组TB-IGRA的阳性率为92.75%,明显高于结核抗体（55.44%）、痰涂片（19.69%）,差异有统计学意义（P〈0.05）;结核病组TB-IGRA的阳性率明显高于非结核病组,差异有统计学意义（P〈0.05）;TB-IGRA具有较好的敏感度（92.75%）、特异度（83.33%）、阳性预测值（93.23%）以及较高的Youden指数值（76.08%）。结论 TB-IGRA用于结核病的诊断简便、快速、敏感、准确,较结核抗体、痰涂片有较大优势,具有较高的临床价值。

Objective To evaluate the clinical value of γ- interferon release test（ TB- IGRA） in the diagnosis of tuberculosis.Methods The clinical data of patients who visited our hospital during September 2014- August 2015 was collected. The tuberculosis（ TB） group contained 193 cases（ including 144 cases of intrapulmonary tuberculosis and 49 cases of extrapulmonary tuberculosis）,and the non tuberculosis group contained 78 cases. TB- IGRA test,tuberculosis antibody gold standard method and sputum smear method were conducted for the detection of Mycobacterium tuberculosis infection,and the results were conducted for statistical analysis and evaluation. Results The positive detection rate of TB- IGRA in intrapulmonary tuberculosis and extrapulmonary tuberculosis were significantly higher than those in tuberculosis antibody gold standard method and sputum smear test,and the difference had statistical significance（ P〈0. 05）; the difference on the positive rates of TB- IGRA in detection of intrapulmonary tuberculosis（ 93. 06%） and extrapulmonary tuberculosis（ 91. 84%） had no statistical significance（ χ~2= 0. 081,P〈0. 05）; the positive rate of TB- IGRA（ 92. 75%） was significantly higher than both tuberculosis antibody（ 55. 44%） and sputum smear（ 19. 69%） in tuberculosis group,and the differences had statistical significance（ P〈0. 05）; the positive rate of TB- IGRA in TB group was obviously higher than that of non TB group,and the difference had statistical significance（ P〈0. 05）; TB- IGRA was with good sensitivity（ 92. 75%）,specificity（ 82. 33%）,positive predictive（ 93. 22%） and Youden index（ 76. 08%）. Conclusion The application of TB- IGRA for the diagnosis of tuberculosis is simple,fast,sensitive and accurate,it has a greater advantage than the tuberculosis antibody gold standard method and the sputum smear method,so TB-IGRA has a high clinical value.