结核感染T淋巴细胞IFN-γ释放实验临床检测分析

Interferon Gamma Release Assays from T Lymphocytes in Patients with Tuberculosis Infection

目的探讨结核感染T淋巴细胞γ干扰素释放试验(IGRAs)在临床检测结核病中的应用价值。方法利用IGRAs方法检测2013~2016年11 968例门诊及住院结核筛查患者。按科室分布分析,同时对检测阳性病例按性别、年龄进行分析比较,并对不确定结果进行分析。另外对不同方法检测结核杆菌感染情况进行比较。结果 11 968例筛查者中,2 048例阳性,阳性率为17.11%,不确定结果 107例,占总检测数的0.89%。2013~2016年检测阳性率分别为19.65%,21.35%,15.82%和13.56%。肺内及肺外结核检测筛查中,呼吸科、消化科、肿瘤科、神经科和妇科阳性率分别为22.07%,20.27%,23.38%,12.84%和11.86%。阳性筛查者中,男性占62.11%,女性占37.89%,男性明显高于女性。按年龄分组,≤15,16~25,26~45,46~65和≥66岁,各年龄段阳性率分别为1.96%,18.51%,16.54%,21.25%和25.73%。分析不确定结果数据,风湿免疫科、血液科比例最高,分别占1.99%和2.35%。与其它实验室检测方法对比,IGRAs方法具有明显优势。结论结核好发于全身各个器官,结核菌感染存在性别、年龄差异。IGRAs是灵敏和特异的快速检测结核分枝杆菌感染的方法,虽不能作为确诊指标,但为进一步确诊疾病,在结核疑似患者筛查中具有较大临床应用价值。

Objective To explore the application value of interferon gamma release assay （IGRAs） in the clinical detection of tuberculosis infected T lymphocytes. Methods Used IGRAs method to detect the 11 968 outpatients and hospitalized pa- tients from 2013 to 2016 with tuberculosis screening. According to the distribution department analysis,also of positive case detection according to age and gender were analysis and comparison and analysis on the uncertainty of results, different methods were compared. Results Among the 11 968 cases,2 048 cases were positive,the positive rate was 17.11 %, and the uncertain result was 107 cases,which accounted for 0.89% of the total number. The positive rates from 2013 to 2016 were 19.65 %, 21.35 %, 15.82 % and 13.56 %, respectively. In the detection and screening of pulmonary and pulmonary tuberculo- sis, the positive ratces of the department of respiration,the digestive department,the oncology department,the department of neurology and the department of gynecology were 22. 07%,20.27%, 23.38%, 12. 84%and 11.86%, respectively. In the positive screening, men accounted for 62.11 %, women accounted for 37.89%, men were significantly higher than women. By age group,was less than or equal to 15,16-25,26-45,46-65,was more than orequal to 66 years old,positive rate were 1.96 %,18.51 % ; 16.54 %, 21.25% and 25.73 %, respectively. Analysis of uncertain outcome data, department of respira- tion, rheumatism, department of hematology, accounted for 1.99% and 2.35 %, respectively. Compared with other laboratory methods,the IGRAs method had obvious advantages. Conclusion Tuberculosis occurs in various body organs, there were differences in gender and age of Mycobacterium tuberculosis infection. IGRAs is a sensitive and specific method for rapid de- tection of Mycobacterium tuberculosis infection, although it can not be used as a diagnostic indicator, but in patients with suspected tuberculosis IGRAs has a larger clinical application value for the further diagnosis of disease.