摘要
目的探讨干扰素体外释放酶联免疫法(IFN-γrelease assay,IGRA)在痰涂片和痰培养均阴性肺结核快速诊断中的应用价值。方法用γ-干扰素检测试剂盒分别检测383例肺结核病患者(包括118例痰涂片或痰培养阳性肺结核患者和265例痰涂片和痰培养均阴性的肺结核患者)、75例其他肺部疾病患者和100例健康对照者结核感染情况并与结核抗体试验(Tuberculosis antibody,TB-AB)比较检测的灵敏度和特异性。结果 TB-IGRA法检测痰涂片和痰培养均阴性及痰涂片或痰培养阳性肺结核患者的阳性检出率分别为90.2%和90.7%,差异无统计学意义(P>0.05);TB-IGRA法和TB-AB试验检测肺结核病患者的灵敏度分别为90.3%和30.0%,TB-IGRA法的灵敏度明显高于TBAB试验(P<0.01)。TB-IGRA法和TB-AB试验的特异性分别为88.0%和89.7%,2种方法特异性差异无统计学意义(P>0.05)。结论 TB-IGRA法检测痰涂片和痰培养均阴性肺结核具有快速和较高的灵敏度和特异性,值得临床推广应用。
Objective To evaluate the clinical application value of T-cell based IFN-γ release assay（ IGRA） in the rapid diagnosis of tuberculosis. Methods The serum specimens from 383 tuberculosis patients（ including 118 pulmonary TB patients with sputum mear-positive or sputum culture-positive and 265 pulmonary TB patients with both sputum smear-and culture-negative）,75 patients with other respiratory diseases and 100 healthy controls were collected to examine the tuberculosis infection status by TB-IGRA. Then the results were statistically analyzed and compared with those of tuberculosis antibody test（ TB-AB） in sensitivity and specificity. Results The positive rates of sputum smear-positive or sputum culture-positive pulmonary TB patients and both sputum-smear and culture-negative pulmonary TB patients were 90. 2% and 90. 7% respectively by TB-IGRA,and there were no significant differences（ P〈 0. 05）. The sensitivities of TB-IGRA and TB-AB were 90. 3% and 30. 0%,respectively,the sensitivity of TB-IGRA was distinctly higher than TB-AB（ P〈 0. 01）. The specificities of TB-IGRA and TB-AB were 88. 0% and 89. 7%,respectively,showing no significant differences（ P〈 0. 05）. Conclusion TB-IGRA is a rapid,sensitive and specific method for detection of sputum smear-and culture-negative pulmonary TB,worthy of being developed and adopted in clinical practice.
出处
《中国卫生检验杂志》
北大核心
2014年第7期949-950,953,共3页
Chinese Journal of Health Laboratory Technology
基金
浙江医学高等专科学校博士基金项目(2013B06)
