γ-干扰素释放试验对筛查藏族肺结核患者的临床应用价值

Clinical application value of IGRA for screening Tibetan patients with pulmonary tuberculosis

目的比较γ-干扰素释放试验(IGRA)在藏族和汉族肺结核人群中的灵敏度和特异度,并探讨其对筛查藏族肺结核患者的临床应用价值。方法选取2013年4月至2015年4月藏族肺结核患者64例,藏族非肺结核患者41例,汉族肺结核患者40例,汉族非肺结核患者38例,行IGRA,以酶联免疫吸附法检测结核分枝杆菌感染T细胞,比较藏汉两族的差异性,并通过计算统计学指标评价IGRA对筛查藏族肺结核患者的临床价值。结果 IGRA对藏族肺结核的诊断灵敏度为90.62%(58/64),特异度为80.49%(33/41),阳性预测值为87.88%(58/66),阴性预测值为84.62%(33/39)。IGRAs对汉族肺结核的诊断灵敏度为92.50%(37/40),特异度为84.21%(32/38),阳性预测值为86.05%(37/43),阴性预测值为91.43%(32/35)。IGRAs对藏汉族肺结核诊断灵敏度差异无统计学意义(χ~2=0.005,P=0.944),IGRA对藏汉族肺结核诊断特异度差异无统计学意义(χ~2=0.018,P=0.893)。结论 IGRA对藏族肺结核的早期诊断价值较高,有利于对早期肺结核的筛查。

Objective To compare the sensitivity and specificity of interferon-gamma release assay（IGRA）in the Tibetan and Han patients with pulmonary tuberculosis（TB）,and to investigate its clinical application value for screening Tibetan patients with pulmonary TB.Methods Sixty-four Tibetan cases of pulmonary TB,41 Tibetan cases of non-pulmonary TB,40 Han cases of pulmonary TB and 38 Han cases of non-pulmonary-TB in our hospital from April 2013 to April 2015 were selected and performed IGRA.T cells infected by mycobacterium tuberculosis were detected by ELISA.The difference between Tibetan abd Han nationalities was compared.The clinical value of IGRAfor screening Tibetan patients with pulmonary TB was evaluated by calculating the statistical indicators.Results The sensitivity,specificity,positive predictive value and negative predictive value of IGRA for diagnosing Tibetan pulmonary TB were 90.62%（58/64）,80.49%（33/41）,87.88%（58/66）and 84.62%（33/39）respectively,which for diagnosing Han patients with pulmonary TB were 92.50%（37/40）,84.21%（32/38）,86.05%（37/43）and 91.43%（32/35）respectively.The sensitivity and specificity of IGRA for diagnosing Tibetan and Han pulmonary TB had no statistical difference（χ~2=0.005,P=0.944;χ~2=0.018,P=0.893）.Conclusion IGRA has high value for early diagnosis of Tibetan pulmonaty TB and is conducive to screening of early pulmonary TB.