外周血CD4^(+)细胞数正常的结核性脑膜炎患儿血IG RAs与TS T比较分析

Comparative Analysis of Blood IGRAs and TST in Children with Tuberculous Meningitis with Normal CD4^(+)Cell Count

目的比较结核性脑膜炎(tuberculous meningitis,TBM)患儿血清γ-干扰素释放试验(interferon gamma release assays,IGRAs)与结核菌素皮肤试验(tuberculin skin test,TST)阳性率,协助判断患儿结核细胞免疫反应。方法收集2018年1月—2021年10月在广州市胸科医院儿科住院并诊断为TBM患儿临床资料共51例作为研究对象,其外周血CD4^(+)细胞数均正常范围。回顾性分析其血清IGRAs、TST结果。结果IGRAs阳性46例,占比90.2%,TST阳性21例,占比41.2%,IGRAs阴性5例,占比9.8%,TST阴性30例,占比58.8%。结论外周血CD4^(+)细胞数正常的TBM患儿IGRAs阳性率比TST高,IGRAs在反映结核细胞免疫反应更有优势。

Objective To compare the positive rates of interferon gamma release assays(IGRAs)and tuberculin skin test(TST)in children with tuberculous meningitis(TBM),and to help judge the immune response of tuberculous cells in children.Methods A total of 51 children diagnosed with TBM who were hospitalized in the Department of Pediatrics,Guangzhou Chest Hospital from January 2018 to October 2021 were collected clinical data as the research object.The CD4^(+)cell count in peripheral blood of all patients was in the normal range.The results of serum IGRAs and TST were analyzed retrospectively.Results 46 cases were positive for IGRAs,accounting for 90.2%,21 cases were positive for TST 41.2%,and 5 cases were negative for IGRAs accounting for 9.8%.There were 30 cases of TST negative,accounting for 58.8%.Conclusion The positive rate of IGRAs in children with tuberculous meningitis with normal CD4^(+)cell count is higher than that of TST,and IGRAs has more advantages in reflecting the immune response of tuberculous cells.