评估γ-干扰素释放试验的临床价值
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高彩莲，孟可俞，殷鹏宇
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北京大学第一医院太原医院检验科，山西太原，030000
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摘要：目的 对结核分枝杆菌感染的三种检测方法的临床应用进行比较，以评价 γ-干扰素释放试验的临床应用价值。方法 收集了某医院 2012-2014 年门诊及住院病人 452 例，其中结核分枝杆菌感染者150 例，非感染者 302 例，通过 γ- 干扰素释放试验 TB—IGRA、结核抗体检测和抗酸杆菌痰涂片细菌学检查镜检法三种方法分别检测了两组患者，并进行相关统计分析实验结果。同时通过该医院检验科的数据系统查找两组患者中入院时所做的血沉、C 反应蛋白，淋巴细胞及其百分比等项目的报告结果，结合判断它们对于结核病诊断的价值。结果 γ-干扰素释放试验TB-IGRA的灵敏度为84.0%，特异度为83.2%，结核抗体检测法的灵敏度为56.7%，特异度为66.2%，抗酸杆菌痰涂片镜检法的灵敏度为46.7%，特异度为93.0%，C反应蛋白的总阳性率为52.8%，血沉的总阳性率为60.4%。结论 TB-IGRA有较高的灵敏度和特异度。结核抗体检测结果不理想。痰涂片镜检有较好的特异度，其阳性结果对结核的诊断有较好的临床意义。在诊断结核时，血沉、C 反应蛋白、淋巴细胞及其百分比并无明显的相关性。
关健词：结核分枝杆菌;γ-干扰素释放试验TB-IGRA;结核抗体;抗酸杆菌
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Evaluate the clinical value of the gamma-interferon release test
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Cailian gao,Keyu meng,Pengyu yin
Department of Laboratory Medicine, Taiyuan Hospital of Peking University First Hospital,Taiyuan Shanxi 030000，China
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Abstract：Objective is to compare the clinical application of three detection Methods for Mycobacterium tuberculosis infectionto evaluate the clinical application value of the γ-interferon release assay (TB-IGRA). Methods From 2012 to 2014, 452outpatients and hospitalized patients from a certain hospital were collected, including 150 cases of Mycobacterium tuberculosisinfection and 302 non-infected cases. The three methods of γ-interferon release assay TB-IGRA, tuberculin antibody detection,and acid-fast bacillus smear bacteriological examination were used to test the two groups of patients, and related statistical analysisof the experimental.Results was conducted. At the same time, the data system of the hospital’s laboratory department wasused to find the results of blood sedimentation rate, C-reactive protein, lymphocyte count, and their percentage in the two groupsof patients upon admission, and to judge their value for the diagnosis of tuberculosis. Results: The sensitivity of the γ-interferonrelease assay TB-IGRA was 84.0%, and the specificity was 83.2%; the sensitivity of the tuberculin antibody detection was56.7%, and the specificity was 66.2%; the sensitivity of the acid-fast bacillus smear examination was 46.7%, and the specificitywas 93.0%; the overall positive rate of C-reactive protein was 52.8%, and the overall positive rate of blood sedimentation ratewas 60.4%.Conclusion TB-IGRA has a higher sensitivity and specificity. The results of tuberculin antibody detection were notideal. The acid-fast bacillus smear examination had a good specificity, and its positive results have a good clinical significancefor the diagnosis of tuberculosis. When diagnosing tuberculosis, blood sedimentation rate, C-reactive protein, lymphocyte count,and their percentage have no obvious correlation.
Keywords : Tuberculosis ；γ- interferon release assay TB-IGRA；uberculosls antibody； tuberculosis acid-fast bacilli
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