摘要
目的探讨胸腔积液行γ-干扰素释放试验(IGRA)对结核性胸膜炎临床诊断价值。方法选取甘孜州人民医院2016年6月至2017年6月收治的结核性胸膜炎患者68例为研究对象(结核组),另选择同期肺炎性胸膜炎患者70例(炎性组)、恶性肿瘤患者70例(恶性组)作为对照,采用酶联免疫吸附试验法(ELISA)行胸腔积液的结核感染T细胞γ-干扰素释放试验(TB-IGRA)检测,同时对结核组患者行外周全血IGRA检测,收集数据并进行统计学分析。结果结核组胸腔积液结核分枝杆菌γ-干扰素体外释放试验(TB-IGRA)检测干扰素-γ(IFN-γ)浓度[179.3(158.1~276.2)ng/L]显著高于炎性组患者胸腔积液的IFN-γ浓度[86.7(55.1~162.2)ng/L]及恶性组患者胸腔积液的IFN-γ浓度[92.7(48.1~178.3)ng/L],差异有统计学意义(P<0.05);外周全血TB-IGRA检测IFN-γ浓度显著低于胸腔积液,差异有统计学意义(P=0.012);胸腔积液TB-IGRA诊断结核性胸膜炎的灵敏度、特异度、阳性预测值、阴性预测值均明显高于外周全血,差异有统计学意义(P<0.05);胸腔积液TB-IGRA诊断核性胸膜炎的ROC曲线下面积高于外周全血。结论胸腔积液TB-IGRA是诊断结核性胸膜炎重要的实验室指标,其诊断效率高于外周全血TB-IGRA。
Objective To investigate the clinical diagnosis value of interferon gamma release assay（IGRA）for pleural effusion in patients with tuberculous pleurisy.Methods 68 patients with tuberculous pleurisy（tuberculous group）were included as object of study in Ganzi state people′s hospital,and selected 70 patients with pneumonic pleurisy（pneumonia group）and 70 patients with malignancy（malignant group）as controls.Enzyme linked immunosorbent assay（ELISA）was used to detect interferon gamma release assay for tuberculosis infected T cells（TB-IGRA）in pleural effusion,and were in progress blood TB-IGRA for tuberculous group.Results The IFN-γlevel of patients in tuberculous group[179.3（158.1-276.2）ng/L]was higher than that those in pneumonia group[86.7（55.1-162.2）ng/L]and malignant group[92.7（48.1-178.3）ng/L],the difference was statistically significant（P〈0.05）.The IFN-γlevel of TB-IGRA for blood was lower than that TB-IGRA for pleural effusion,the difference was statistically significant（P=0.012）.The sensitivity,specificity,positive predictive value,and negative predictive value of TB-IGRA for pleural effusion higher than that blood TB-IGRA,the difference was statistically significant（P〈0.05）.The AUC of TB-IGRA for pleural effusion was higher than that blood TB-IGRA.Conclusion TB-IGRA for pleural effusion is an important laboratory index for the diagnosis of tuberculous pleurisy,and its diagnostic efficiency is higher than that of blood TB-IGRA.
作者
李素英
余海霞
杨红
LI Suying;YU Haixia;YANG Hong(Department of Blood Transfusion;Department of Clinical Laboratory,Ganzi state People＇s Hospital,Ganzhi,Sichuan 626000,China;Department of Infectious diseases,Infection Hospital of Ganzi state People＇s Hospital,Ganzhi,Sichuan 626000,China)
出处
《国际检验医学杂志》
CAS
2018年第13期1593-1596,共4页
International Journal of Laboratory Medicine
基金
四川省卫生计划委员会科研课题支持(150060)
