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目的探讨T细胞γ-干扰素释放试验(TB-IGRA)在肺结核患者诊疗中的价值。方法随机选取2014年3月-2016年3月在沈阳市第十人民医院初次确诊的肺结核病患者142例为观察组,另选取46名健康体检者作为对照组,采集其外周血后用酶联免疫法检测结核特异性T细胞γ-干扰素的含量,同时与结核菌素纯蛋白质衍生物(PPD)试验检测结果进行比较。结果两组治疗前TB-IGRA、PPD阳性率差异有统计学意义(P<0.05)。观察组和对照组诊断肺结核的阳性预测值分别为97.28%、91.82%,阴性预测值分别为77.23%、31.48%,敏感性分别为90.52%、47.78%,特异性分别为94.35%、74.85%,组间对比差异均有统计学意义(P<0.05)。结论 TB-IGRA在肺结核患者诊疗中的敏感性、特异性均较高,TB-IGRA对提高肺结核感染的阳性检出率有很大帮助,可将其作为肺结核临床诊断的一种重要辅助手段。
Objective To investigate the value of T-cell interferon-gamma release assay (TB-IGRA) in diagnosis and treatment of pulmonary tuberculosis patients. Methods A total of 142 patients with tuberculosis diagnosed at the 10th People’s Hospital of Shenyang City from March 2014 to March 2016 were randomly selected as the observation group and 46 healthy subjects were selected as the control group. The level of IFN-γ in tuberculosis-specific T cells was detected by immunoassay, and compared with the results of the test of tuberculin pure protein derivative (PPD). Results The positive rates of TB-IGRA and PPD before treatment in both groups were significantly different (P <0.05). The positive predictive value of tuberculosis in the observation group and the control group were 97.28% and 91.82%, respectively. The negative predictive value were 77.23% and 31.48% respectively. The sensitivity and specificity were 90.52%, 47.78% and 94.35%, 74.85% The differences between the two groups were statistically significant (P <0.05). Conclusion The sensitivity and specificity of TB-IGRA in the diagnosis and treatment of pulmonary tuberculosis patients are high. TB-IGRA is very helpful to improve the positive detection rate of TB infection, which can be used as an important adjunct to clinical diagnosis of TB.