γ-干扰素释放试验在潜伏结核感染治疗效果评价中的应用价值

Application value of interferon gamma release assay in evaluation of curative effect of latent tuberculosis infection

目的探讨γ-干扰素释放试验(IGRA)在潜伏结核感染(LTBI)治疗效果评价中的应用价值。方法采用回顾性分析,选取2020年1—5月浙江省湖州市中心医院收治的结核感染患者作为研究对象,随机抽取LTBI 30例作为试验组,进行预防性抗结核治疗(TPT)。随机抽取肺结核患者30例作为对照组,进行规范抗结核治疗。比较两组治疗开始时、治疗后3个月的IGRA值。结果治疗开始时,试验组的IGRA值为(329.53±255.34)pg/ml,对照组的IGRA值为(451.84±260.59)pg/ml,两组的IGRA值比较,差异无统计学意义(P>0.05)。治疗3个月时,试验组的IGRA值中位数为[13.50(10.00,70.00)]pg/ml,对照组的IGRA值中位数为[52.15(12.75,110.35)]pg/ml,试验组的IGRA值低于对照组,差异有统计学意义(P<0.05)。试验组的IGRA值阴转15例(50.0%),对照组IGRA值阴转8例(26.7%),两组的IGRA阴转情况比较,差异无统计学意义(P>0.05)。组内比较,对照组和试验组治疗后的IGRA值均较前下降,差异有统计学意义(Z=5.872;Z=5.360,P<0.001)。结论在LTBI中,IGRA值变化的程度优于普通肺结核病人。IGRA的动态变化可为LTBI治疗效果评价提供依据。

Objective To explore the application value of interferon gamma release assay(IGRA)in the evaluation of the curative effect of latent tuberculosis infection(LTBI).Methods In a retrospective analysis,patients with tuberculosis infection who were admitted to Huzhou Central Hospital,Zhejiang Province from January to May 2020 were selected as the study subjects,and 30 patients with LTBI were randomly selected as the experimental group to receive preventive anti-tuberculosis therapy(TPT).Another 30 patients with tuberculosis were randomly selected as the control group to receive standard anti-tuberculosis treatment.The IGRA values at the beginning of treatment and 3 months after treatment were compared between the two groups.Results At the beginning of treatment,the IGRA value of the experimental group was(329.53±255.34)pg/ml,and that of the control group was(451.84±260.59)pg/ml,with no statistically significant difference in the IGRA value between the two groups(P>0.05).After 3 months of treatment,the median value of IGRA in the experimental group was(13.50[10.00,70.00])pg/ml,while the median value of IGRA in the control group was(52.15[12.75,110.35])pg/ml,and the value of IGRA in the experimental group was lower than that in the control group,with a statistically significant difference(P<0.05).In the experimental group,15 patients(50.0%)had negative IGRA,while in the control group,8 patients(26.7%)had negative IGRA,with no statistically significant difference in the negative IGRA between the two groups(P>0.05).Within the group,IGRA values of both the control group and the experimental group were decreased after treatment,and the differences were statistically significant(Z=5.872;Z=5.360,P<0.001).Conclusion In LTBI,the degree of change in the IGRA value is better than that in normal tuberculosis patients.The dynamic changes of IGRA provide a basis for the evaluation of the LTBI therapeutic effect.