胸水γ-干扰素释放试验在诊断结核性胸膜炎中的应用

Application of chest water interferon-gamma release assays in the diagnosis of tuberculous pleurisy

目的探讨胸水γ-干扰素释放试验在诊断结核性胸膜炎中的应用效果及与用聚合酶链式反应检测结核分枝杆菌DNA的应用效果的比较分析。方法选取2015年3月-2017年9月住院并伴有发热、畏寒、出汗、乏力及胸腔积液明显增多、临床高度怀疑结核性胸膜炎的患者363例作为研究对象,在其用药前采集胸水分别进行γ-干扰素释放试验和结核分枝杆菌DNA的检测。结果结核性胸膜炎组108例中105例IFN-γ阳性,与TB-DNA结果一致,符合率为97.22%。非结核性胸膜炎组255例中245例IFN-γ阴性,TB-DNA结果一致符合率为96.08%。2组结果的一致性比较差异无统计学意义(P>0.05)。结论γ-干扰素释放试验与用聚合酶链式反应检测结核分枝杆菌DNA同样可以用于结核性胸膜炎的诊断。

Objective To investigate the application of chest water interferon-gamma(IFN-γ) release assays(IGRA) in the diagnosis of tuberculous pleurisy,and to compare the application efficiency in the detection of DNA(TB-DNA) of Mycobacterium tuberculosis by PCR.Methods From March 2016 to September 2017,363 patients with fever,chills,sweating,fatigue,and increased details of pleural effusion were selected for study.Before drug use,chest water was collected and tested by IGRA and TB-DNA,respectively.Results In 108 cases of tuberculous pleurisy,105 cases were positive for IFN-γ,and the results were consistent with those of TB-DNA.The coincidence rate was 97.22%.In 255 of non tuberculous pleurisy group,245 cases were negative for IFN-γ,and the TB-DNA coincidence rate was 96.08%.There was no statistical significance on the difference in consistency between the two groups(P>0.05).Conclusion IFN-γ release test can be used for the diagnosis of tuberculous pleurisy,and PCR method can also used to detect the DNA of Mycobacterium tuberculosis.