γ-干扰素释放试验对不同年龄段患者结核杆菌感染的诊断价值

Diagnostic value of interferonγ-release assay in different age groups of patients with Mycobacterium tuberculosis infection

目的分析γ-干扰素释放试验(IGRA)在不同年龄患者结核杆菌感染中的诊断价值。方法选择2018年1月-2019年6月在武威医学科学院住院治疗的208例疑似结核病患者作为研究对象,根据年龄分为青年组70例(18~44岁),中年组50例(45~59岁),老年组88例(≥60岁)。所有患者入院后均进行IGRA及其他相关辅助检查,比较各组IGRA结果与诊断结果,分析IGRA结果在不同年龄组结核杆菌感染患者中的诊断效能。结果青年组、中年组、老年组的IGRA诊断敏感度分别为96.88%、89.47%和73.44%,特异度分别为50.00%、75.00%和83.33%,准确度分别为92.85%、86.00%、76.14%,阳性预测值分别为95.38%、91.89%和92.16%,阴性预测值分别为60.00%、69.23%和54.05%。青年组IGRA诊断敏感度明显高于中年组和老年组〔96.88%(62/64)比89.47%(34/38)、73.44%(47/64),均P<0.05〕。结论 IGRA对青年结核病患者有较好的辅助诊断价值,但对于中年及老年患者的诊断效能相对较低。

Objective To analyze the diagnostic value of interferonγ-release assay(IGRA)in different age groups of patients with tuberculosis.Methods The 208 suspected tuberculosis patients hospitalized in Wuwei Academy of Medical Scienses from January 2018 to June 2019 were selected as research objects.According to age,the patients were divided into young group(18-44 years old,70 cases),middle-aged group(45-59 years old,50 cases)and old group(≥60 years old,88 cases).After admission,all the patients were tested for IGRA and other relevant auxiliary inspection were performed.The results of IGRA and diagnosis of each group were compared,and the results of IGRA in patients with tuberculosis infection in different age groups were analyzed.Results In young,middle-aged and old groups,the sensitivity was 96.88%,89.47%and 73.44%,the specificity was 50.00%,75.00%and 83.33%,the accuracy was 92.85%,86.00%and 76.14%,the positive predictive value was 95.38%,91.89%and 92.16%,and the negative predictive value was 60.00%,69.23%and 54.05%,respectively.The sensitivity of IGRA in young group was significantly higher than those in middle-aged and old groups[96.88%(62/64)vs.89.47%(34/38),73.44%(47/64),both P<0.05].Conclusion IGRA has a good auxiliary diagnostic value for young patients with tuberculosis,but its diagnostic efficacy for middle-aged and old patents is relatively low.