T细胞γ-干扰素释放试验对肺结核的诊疗价值

The value of T cell interferon gamma release test in the diagnosis and treatment of pulmonary tuberculosis patients

目的探讨T细胞γ-干扰素释放试验(TB-IGRA)在肺结核患者诊疗中的价值。方法随机选取2014年3月-2016年3月在沈阳市第十人民医院初次确诊的肺结核病患者142例为观察组,另选取46名健康体检者作为对照组,采集其外周血后用酶联免疫法检测结核特异性T细胞γ-干扰素的含量,同时与结核菌素纯蛋白质衍生物(PPD)试验检测结果进行比较。结果两组治疗前TB-IGRA、PPD阳性率差异有统计学意义(P<0.05)。观察组和对照组诊断肺结核的阳性预测值分别为97.28%、91.82%,阴性预测值分别为77.23%、31.48%,敏感性分别为90.52%、47.78%,特异性分别为94.35%、74.85%,组间对比差异均有统计学意义(P<0.05)。结论 TB-IGRA在肺结核患者诊疗中的敏感性、特异性均较高,TB-IGRA对提高肺结核感染的阳性检出率有很大帮助,可将其作为肺结核临床诊断的一种重要辅助手段。

Objective To explore the T cell interferon gamma release test （TB-IGRA） in the diagnosis and treatment of patients with pulmonary tuberculosis in value. Methods From March 2014 to March 2016, 142 cases of first time diagnosed as pulmonary tuberculosis patients were randomly selected in our hospital as observation group and 46 healthy people as control group. The content of ^- interferon in tuberculosis- specific T cells was detected by enzyme- linked immunosorbent assay （ELISA） , and the results were compared with those of tuberculin pure protein derivative （PPD） test. Results The positive rates of TB-IGRA and PPD before and after treatment in the two groups was significantly different （P〈 0.05）. The positive predictive values, negative predictive values, sensitivities and specificities of tuberculosis in the observation group and control group were 97.28% and 91.82%, 77.23% and 31.48%, 90.52% and 47.78%, and 94.35% and 74.85%, respectively. The differences were statistically significant （P〈0.05）. Conclusion The sensitivity and specificity of T-cell interferon gamma release test （TB- IGRA ） in the diagnosis and treatment of pulmonary tuberculosis patients were high. TB-IGRA application can help to improve the detection of tuberculosis infection, and can be used as an important supplementary means for diagnosis of pulmonary tuberculosis.