TB-IGRA在结核病诊断中的应用价值

目的 评价全血γ-干扰素释放酶联免疫试验（TB-IGRA）在结核病诊断中的应用价值.方法 选择2013年1月至2013年8月在我院住院的患者161例,分为结核病组103例（其中肺内结核78例,肺外结核25例）,非结核病组58例.入院时进行TB-IGRA、结核菌素皮肤试验（TST）、血清结核抗体（TB-AB）及痰涂片检查等.结果 结核病组和非结核病组TB-IGRA的阳性率分别为90.3％和18.9％,结核病组TB-IGRA阳性率明显高于非结核病组,差异有统计学意义（P＜0.01）.TB-IGRA诊断结核病的敏感性（89.42％）明显高于TST（72.71％）、TB-AB（64.90％）、痰涂片（25.71％）（P＜0.01）.血TB-IGRA、TST、TB-AB、痰涂片的诊断特异性分别为82.46％、77.21％、53.72％、42.03％.血TB-IGRA对结核病的阳性和阴性预测值分别为90.29％和81.03％.结论 TB-IGRA用于结核病的诊断简便、快速、敏感、准确有效,具有较高的临床应用价值。

Application of interferon gamma release assay for tuberculosis diagnosis

Objective To evaluate the application of interferon gamma release assay （IGRA） for tuberculosis diagnosis.Methods Patients admitted into our hospital from January 2013 to August 2013 were enrolled in the study,including 103 TB patients （78 intrapulmonary cases vs 25 extrapulmonary cases） and 58 non-TB patients.They underwent IGRA test,tuberculin skin test （TST）,and serum tuberculosis antibody （TB-AB） and sputum smear examinations.Results The positive rate was 90.3% for TB patients,which was remarkably higher that 18.9% in non-TB patients （P 〈0.01）.TB-IGRA test presented higher sensitivity （89.42%） over tuberculosis diagnosis when compared with TST （72.71%）,TB-AB （64.90%） or sputum smear （25.71%） （P 〈0.01）.The specificity was 82.46% for TB-IGRA,77.21% for TST,53.72% for TB-AB and 42.03% for sputum smear.TB-IGRA showed a positive predictive value of 90.29% and a negative predictive value of 81.03%.Conclusions TB-IGRA is a convenient and rapid method to diagnose tuberculosis with high sensitivity and accuracy,which is suitable for clinical application.