γ干扰素释放试验联合IL-6检测对活动性肺结核的诊断价值

Diagnostic value of interferon gamma release assays combined with IL-6 detection in active pulmonary tuberculosis

目的探讨γ-干扰素释放试验(IGRA)联合白细胞介素-6(IL-6)检测对活动性肺结核的诊断价值。方法选取2018年6月-2019年6月同济大学附属上海市肺科医院收治的700例结核病患者作为研究对象,其中包含活动性肺结核患者587例(A组)和非活动性肺结核患者113例(B组),另取同期该院体检的100例健康人群作为对照组。比较3组IGRA阳性率及血清IL-6水平。采用ROC曲线评价IGRA、IL-6对活动性肺结核的诊断效能。结果3组血清IL-6水平及IGRA阳性率比较,差异有统计学意义(P<0.05),A组高于B组及对照组(P<0.05),且B组高于对照组(P<0.05)。通过ROC曲线分析,IGRA诊断活动性肺结核的敏感性、特异性分别为80.92%(95%CI:77.74,158.66)和70.80%(95%CI:62.41,133.21)。IL-6≥20.24 ng/L时,其敏感性、特异性分别为74.79%(95%CI:71.27,146.06)和83.19%(95%CI:76.29,159.48);两者联合诊断的敏感性、特异性分别为84.33%(95%CI:81.39,165.71)和85.84%(95%CI:79.41,165.25)。结论IGRA、IL-6对活动性肺结核具有较高的诊断价值,且两者联合的敏感性、特异性更高,可用于临床中活动性肺结核的辅助诊断。

Objective To investigate the diagnostic value of interferonγrelease assay(IGRA)combined with IL-6 detection in active pulmonary tuberculosis.Methods Seven hundred pulmonary tuberculosis patients admitted to our hospital were selected as the research objects from June 2018 to June 2019,including 587 active pulmonary tuberculosis patients and 113 non-active pulmonary tuberculosis patients,100 healthy people who were admitted to hospital for physical examination in the same period were selected as the control.The results of IGRAs and the level of IL-6 were compared among the three groups.ROC curve was used to evaluate the diagnostic efficacy of IGRAs and serum IL-6 in active pulmonary tuberculosis.Results The difference of serum IL-6 content and IGRAs positive rate among the three groups was statistically significant(P<0.05),and A group was higher than B group and healthy control group(P<0.05),B group was higher than healthy control group(P<0.05).The sensitivity and specificity of IGRA in the diagnosis of active tuberculosis were 80.92%and 70.80%,respectively,according to ROC curve analysis;when the value of IL-6 was 20.24 ng/L,the sensitivity and specificity were 74.79%and 83.19%,respectively;the sensitivity and specificity of combined diagnosis were 84.33%and 85.84%,respectively.Conclusion IGRA and IL-6 have high diagnostic value for active pulmonary tuberculosis,and their combined sensitivity and specificity are higher,which can be used for the auxiliary diagnosis of active pulmonary tuberculosis in clinic.