天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (9): 1132-1135.doi: 10.11958/20160397

• 临床研究 • 上一篇    下一篇

全血 γ 干扰素释放试验诊断结核病的临床应用价值

孔海芳1,岳娜1,刘刚2,李妍淳1,田彬1,胡志东3   

  1. 1 天津医科大学总医院医学检验科（邮编 300052）；2天津市海河医院检验科
  • 收稿日期:2016-05-09 修回日期:2016-06-19 出版日期:2016-09-15 发布日期:2016-09-28
  • 通讯作者: 胡志东 E-mail:konghaifang01@163.com
  • 作者简介:孔海芳（1990）， 女， 硕士在读， 主要从事细菌耐药方面的研究

The diagnosis value of the whole blood interferon-γ release assay in tuberculosis

KONG Haifang1, YUE Na1, LIU Gang2, LI Yanchun1, TIAN Bin1, HU Zhidong1△   

  1. 1 Department of Laboratory Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China； 2 Tianjin Haihe Hospital Laboratory
  • Received:2016-05-09 Revised:2016-06-19 Published:2016-09-15 Online:2016-09-28
  • Contact: HU Zhidong E-mail:konghaifang01@163.com

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摘要： 目的 评价全血 γ 干扰素（IFN-γ）释放试验（QFT-GIT）诊断结核病的临床应用价值。 方法 收集天津医科大学总医院 2014 年 10 月—2015 年 10 月 109 例（确诊病例 45 例， 临床诊断病例 64 例）结核病患者（结核组）和 70 例非结核呼吸系统疾病患者（非结核组）资料， 同时采用 QFT-GIT、胶体金抗结核抗体（TB-Ab）进行检测， 绘制 IFN-γ 释放量受试者工作者特征（ROC）曲线， 比较 2 种方法的诊断价值及 QFT-GIT 试验在 2 组中的差异。 结果 QFT-GIT 对结核病的诊断敏感度为 93.58%， 特异度为 85.71%， 其诊断阳性率高于 TB-Ab（χ2=43.68， P＜ 0.01）。 2 种方法联合检测的敏感度降至 52.29%（57/109）， 但特异度增加至 90.00%（63/70）。 结核组 IFN-γ 释放量明显高于非结核组（U=330， P＜ 0.05）， IFN-γ 释放量 ROC 曲线下面积为 0.913（95%CI： 0.864~0.963）。 结论 QFT-GIT 试验在结核病诊断中具有较高的敏感度和特异度， 与 TB-Ab 联合检测可进一步提高诊断的特异度， 为临床结核病的诊断提供及时有效的依据。

关键词: 结核, 卡介苗, 诊断试验, 常规, 敏感性与特异性, ROC 曲线, &gamma, 干扰素释放试验, 结核抗体

Abstract: Objective To evaluate the clinical application of the whole blood interferon γ (IFN-γ) release assay of QuantiFERON TB Gold in tube (QFT-GIT) in diagnosis of tuberculosis. Methods From October 2014 to October 2015, 109 patients with tuberculosis (45 cases of confirmed patients and 64 cases of clinically diagnosed patients) and 70 patients with non-tuberculosis were enrolled in Tianjin Medical University General Hospital. In order to evaluate diagnosis value between two kinds of tests, and to compare the differences between two groups, QFT- GIT test and colloidal gold anti tuberculosis antibody (TB-Ab) were employed to detect in two groups of patients. The ROC curve of IFN-γ release quantity was analyzed in two groups. Results The sensitivity and specificity of QFT-GIT were 93.58% and 85.71% respectively. The positive rate was significantly higher in QFT-GIT than that of TB-Ab (χ2=43.68， P＜ 0.01). The sensitivity of combined detection of the two methods decreased to 52.3% (57/109), but the specificity increased to 90.0% (63/70). The release quantity of IFN-γ was significantly higher in tuberculosis group than that in the non-tuberculosis group (U=330， P<0.05). The area under the ROC curve of IFN-γ release quantity was 0.913 (95%CI: 0.864-0.963). Conclusion The whole blood IFN-γ release assay of QFT-GIT is a sensitive and specific assay for detecting tuberculosis infection. The combination QFTGIT with TB-Ab can improve the specificity further, which could be a useful tool for the diagnosis of tuberculosis ．

Key words: tuberculosis, BCG vaccine, diagnostic tests, routine, sensitivity and specificity, ROC curve, interferon- &gamma, release assay, TB-Ab