TB-IGRA联合HLA-G检测对结核分枝杆菌感染患者的诊断效果评价

Effect of TB-IGRA combined with HLA-G on diagnosis of patients with Mycobacterium tuberculosis infection

目的探究结核分枝杆菌干扰素-γ(INF-γ)释放试验(tuberculosis interferon-gamma release assay,TBIGRA)联合人白细胞分化抗原-G分子(human leukocyte antigen-G,HLA-G)检测对肺部结核分枝杆菌感染患者的诊断效果。方法选取2016年1-12月于医院进行治疗的肺部疾病患者197例为研究对象,根据患者的病理检测结果分为肺结核组151例及非肺结核肺炎组46例,同时选取同期健康体检者44例对照组,比较TB-IGRA、sHLA-G、mHLA-G水平与诊断效用。结果肺结核组患者IFN-γ含量为178.50(167.76,277.29)ng/L,sHLA-G含量为99.40(87.44,172.91)U/mL,mHLA-G含量为13.97%(11.45%,15.41%)均高于非肺结核肺炎组和健康对照组(P<0.05);TB-IGRA+sHLA-G+mHLA-G三项指标联合的敏感度和特异度分别为89.13%、81.24%均高于单独检测(P<0.05)。结论 TB-IGRA联合HLA-G检测,敏感度、特异度好,准确度高,对于肺结核的临床诊断具有一定指导意义。

OBJECTIVE To explore the effect of tuberculosis interferon-gamma release assay（TB-IGRA）combined with human leukocyte antigen-G（HLA-G）on diagnosis of the patients with Mycobacterium tuberculosis infection.METHODS A total of 197 patients with pulmonary diseases who were treated in the hospital from Jan 2016 to Dec 2016 were recruited as the study objects and divided into the tuberculosis group with 151 cases and the non-tuberculosis pneumonia group with 46 cases according to the result of pathological examination,meanwhile,44 healthy people who received physical examination were chosen as the control group.The levels of TB-IGRA,sHLA-G and mHLA-G and the diagnostic effects were observed and compared.RESULTS The contents of IFN-γ,sHLA-G and mHLA-G of the tuberculosis group were respectively 178.50（167.76,277.29）ng/L,99.40（87.44,172.91）U/mL and 13.97%（11.45%,15.41%）,significantly higher than those of the non-tuberculosis pneumonia group and the control group（P〈0.05）.The sensitivity and specificity of the joint detection of TB-IGRA plus sHLA-G plus mHLA-G were respectively 89.13% and 81.24%,significantly higher than those of the detection of single index（P 0.05）.CONCLUSION The TBIGRA combined with HLA-G show high sensitivity,specificity and accuracy,and it has certain significance in guiding the clinical diagnosis of the tuberculosis patients.