γ-干扰素释放试验QFT-GIT与结核病原学结果不一致影响因素分析

Influencing factors of inconsistency betweenγ-interferon release test QFT-GIT and tuberculosis etiological test results

目的探讨γ-干扰素释放试验QFT-GIT与病原学结果不一致的影响因素。方法回顾性分析2017年9月至2021年8月在浙江大学医学院附属杭州市胸科医院收治的进行QFT-GIT试验后经培养确诊结核分枝杆菌阳性的1398例患者临床资料。以病原学培养结果为标准,QFT-GIT结果阳性为结果一致组(n=1242),阴性及不确定为结果不一致组(n=156)。采用Logistic回归分析QFT-GIT与结核病原学结果不一致的影响因素。采用SPSS 25.0软件对数据进行分析。结果QFT-GIT与结核病原学结果不一致发生率为11.16%(156/1398)。<18岁、18~<65岁和≥65岁人群QFT-GIT与结核病原学结果不一致发生率分别为0、7.09%(63/889)和19.58%(93/475)。≥65岁人群不一致的发生率高于<18岁和18~<65岁人群(χ^(2)=6.584和36.762,P<0.01)。多因素Logistic回归分析显示,年龄(OR=1.026,95%CI 1.016~1.037)、吸烟(OR=1.649,95%CI 1.159~2.347)、慢性肝病(OR=1.868,95%CI 1.213~2.876)、心血管疾病(OR=2.353,95%CI 1.361~4.069)及白蛋白(OR=0.956,95%CI 0.928~0.985)是QFT-GIT与结核病原学结果不一致发生的独立影响因素。结论高龄、吸烟、慢性肝病、心血管疾病和低白蛋白水平患者更易发生QFT-GIT与结核病原学结果不一致。

Objective To evaluate the influencing factors of inconsistency betweenγ-interferon release test QFT-GIT and etiological results in tuberculosis patients.Methods The clinical data of 1398 patients with positive Mycobacterium tuberculosis infection confirmed by pathogen culture after QFT-GIT test who were admitted to Hangzhou Chest Hospital Affiliated to Zhejiang University School of Medicine from September 2017 to August 2021 were retrospectively analyzed.There were 1242 cases in whom both the pathogenic culture and QFT-GIT results were positive(consistent result group)and 156 cases in whom the QFT-GIT test results were negative or indeterminate(inconsistent result group).Logistic regression was used to analyze the influencing factors of inconsistent results between QFT-GIT and tuberculosis pathogenic tests.SPSS 25.0 software was used to analyze the data.Results The overall incidence of inconsistency between QFT-GIT and tuberculosis etiological results was 11.16%(156/1398).The incidence of inconsistency was 0,7.09%(63/889)and 19.58%(93/475)in patients aged<18,18-<65 and≥65 years old,respectively;the incidence of inconsistency in age group≥65 was higher than that in age groups<18 and 18-<65(χ^(2)=6.584 and 36.762,P<0.01).Multivariate Logistic regression analysis showed that age(OR=1.026,95%CI 1.016-1.037),smoking(OR=1.649,95%CI 1.159-2.347),chronic liver disease(OR=1.868,95%CI 1.213-2.876),cardiovascular disease(OR=2.353,95%CI 1.361-4.069)and blood albumin level(OR=0.956,95%CI 0.928-0.985)were independent influencing factors for the inconsistency between the results of QFT-GIT and tuberculosis etiology.Conclusion Patients with advanced age,smoking,chronic liver disease,cardiovascular disease and low albumin level are more likely to have inconsistent results between QFT-GIT and tuberculosis etiological tests.