结核菌素皮肤试验和γ干扰素释放试验诊断高危人群潜伏性结核感染的影响因素分析

Influencing Factors of Tuberculin Skin Test and Interferon-gamma Release Test in the Diagnosis of Latent Tuberculosis Infection in High-risk Population

目的探讨结核菌素皮肤试验(tuberculin skin test,TST)和γ干扰素释放试验(interferon gamma release assays,IGRAs)诊断高危人群潜伏性结核感染(latent tuberculosis infection,LTBI)的影响因素。方法选择我院2016年1—7月住院肺结核患者的陪护人员138例(密切接触组)、结核科医务人员89例(医务人员组)及健康体检者50例(对照组),3组分别进行TST和IGRAs试验,比较各组检测结果;同时行问卷调查了解密切接触组和医务人员组结核病接触与结核病预防接种等相关信息,分析TST和IGRAs试验阳性的相关影响因素。结果密切接触组、医务人员组TST试验阳性率均显著高于对照组(P<0.05),密切接触组IGRAs试验阳性率显著高于医务人员组和对照组(P<0.05)。是否接种卡介苗、与接触者关系和接触时间为密切接触组TST试验阳性的影响因素,接触时间和是否营养不良为密切接触组IGRAs试验阳性的影响因素。结论在高危人群中应用TST和IGRAs试验诊断LTBI需排除相关影响因素的干扰。

Objective To analyze the influencing factors of two kinds of trials in the diagnosis of latent tuberculosis infection(LTBI)in high-risk population by tuberculosis bacterium screening in the medical staff at risk for tuberculosis infection.Methods A total of 138 caregivers in close contact with TB patients(close contact group),89 tuberculosis professionals(tuberculosis professional group),and 50 healthy persons(control group)were enrolled in our hospital from January 2016 to July 2016.The three groups underwent tuberculin skin test(TST)and interferon-gamma release test(IGRAs)respectively,and a questionnaire survey was conducted to collect the information on tuberculosis contact and vaccination.Results The positive rate of TST was significantly higher in close contact group and tuberculosis professional group than in control group(P<0.05).The positive rate of IGRAs was remarkably higher in close contact group than in both tuberculosis professional group and control group(P<0.05).BCG vaccination,relationship with the contacts and length of contact were influencing factors of positive reaction in TST in close contact group,as with length of contact and malnutrition in IGRAs in this group.Conclusion In terms of diagnosis of LTBI by TST and IGRAs in high risk population,the influencing factors should be excluded.