摘要
目的探讨干扰素体外释放酶联免疫检验(IGRA)在结核病临床诊断中的应用价值。方法选择2022年9月—2023年9月在菏泽市传染病医院经初步检查怀疑为结核病的530例患者作为研究对象,对所有患者实施IGRA和结核菌素皮肤试验,以结核杆菌DNA检测结果作为诊断的“金标准”,比较应用IGRA与结核菌素皮肤试验诊断结核病所得诊断结果,分析两种方法诊断结核病的结果与结核杆菌DNA检测结果的一致性。结果在530例疑似结核病患者中,经结核杆菌DNA检测共412例患者确诊结核病(包括肺结核329例,肺外结核83例),检出率为77.74%。IGRA诊断结核病的敏感度、特异度、阳性预测值、阴性预测值、准确度均显著高于结核菌素皮肤试验(敏感度:98.30%比95.15%;特异度:97.46%比88.98%;阳性预测值:99.26%比96.79%;阴性预测值:94.26%比84.00%;准确度:98.11%比93.77%;均P<0.05)。IGRA和结核菌素皮肤试验诊断结核病的结果与结核杆菌DNA检测结果的一致性分析表明,IGRA与结核杆菌DNA检测结果高度一致(κ值为0.894),结核菌素皮肤试验与结核杆菌DNA检测结果中度一致(κ值为0.657)。结论在对结核病进行诊断时,应用IGRA进行检测具有较高的诊断价值,可实现对结核病的灵敏和准确诊断。
Objective To explore the application value of interferon in vitro release enzyme linked immunosorbent assay(IGRA)in the clinical diagnosis of tuberculosis.Methods The 530 patients suspected of tuberculosis after preliminary examination in Heze Infectious Diseases Hospital from September 2022 to September 2023 were selected as research objects.IGRA and tuberculin skin test were performed on all the patients suspected of tuberculosis.The results of Mycobacterium tuberculosis DNA test were used as"gold standard"for tuberculosis diagnosis.The diagnostic results of tuberculosis diagnosed by IGRA and tuberculin skin test were compared,and the consistency level between the results of tuberculosis diagnosed by two methods and the results of Mycobacterium tuberculosis DNA test was analyzed.Results Among 530 patients suspected of tuberculosis,412 patients were diagnosed with tuberculosis(including 329 cases of pulmonary tuberculosis and 83 cases of extrapulmonary tuberculosis)by Mycobacterium tuberculosis DNA test,with the detectable rate of 77.74%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of IGRA in the diagnosis of tuberculosis were significantly higher than those of tuberculin skin test(sensitivity:98.30%vs.95.15%;specificity:97.46%vs.88.98%;positive predictive value:99.26%vs.96.79%;negative predictive value:94.26%vs.84.00%;accuracy:98.11%vs.93.77%;all P<0.05).The consistency analysis between the results of IGRA and tuberculin skin test for diagnosis of tuberculosis and the results of Mycobacterium tuberculosis DNA test showed that IGRA and Mycobacterium tuberculosis DNA test were highly consistent(value was 0.894),while the results of tuberculin skin test and Mycobacterium tuberculosis DNA test were moderately consistent(value was 0.657).Conclusion In the diagnosis of tuberculosis,the use of IGRA detection has high diagnostic value,which could achieve sensitive and accurate diagnosis of tuberculosis.
作者
常斐
Chang Fei(Department of Clinical Laboratory,Heze Infectious Disease Hospital,Heze 274000,Shandong,China)
出处
《实用检验医师杂志》
2024年第3期266-269,共4页
Chinese Journal of Clinical Pathologist
关键词
结核病
诊断
干扰素体外释放酶联免疫检验
结核菌素皮肤试验
Tuberculosis
Diagnosis
Interferon in vitro release enzyme linked immunoassay assay
Tuberculin skin test
