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背景:在进行大规模接触者调查后,对结核菌素试验(TST)阳性个体提供预防性抗结核治疗。目的:研究随访期间异烟肼(INH)的治疗效果和γ-干扰素释放试验(IGRA)的时效。设计:在大规模接触者调查期间,TST检测为阳性的对象(n=122例)纳入本研究。在2年里,每6个月抽取一次血标本用来进行两种试验。结果:122例中,36例(29.5%)完成异烟肼预防性治疗,71例(58.2%)每6个月进行一次X线筛查随访,另有15例(12.3%)未完成异烟肼预防性治疗。阳性者的总百分率在2年间保持稳定,大约在45%～50%,但随着时间的推移,个体的反应有变化。大多数初始IGRA低者,随访期间其结果仍然在临界值以下,初始IGRA结果高的仍为阳性,而IGRA初始结果为中等程度者,随访期间有多种动态类型。结论:本研究显示IGRA反应随着时间推移变异较大,提示其在潜伏感染个体随访中的应用价值有限。然而,在那些初始IGRA为中等程度结果的个体表现出不同动态类型的意义,需要进一步研究。
Background: Prophylactic antituberculosis treatment is provided to individuals with positive TST markers after conducting a large-scale contact investigation. PURPOSE: To investigate the therapeutic effect of isoniazid (INH) and the duration of interferon-gamma release (IGRA) during follow-up. DESIGN: Subjects with a positive TST test (n = 122) were included in this study during a large-scale contact investigation. In two years, blood samples were taken every six months for both trials. Results: Of the 122 patients, 36 (29.5%) were treated with isoniazid prophylaxis, 71 (58.2%) were followed up every 6 months and another 15 (12.3%) were not yet cured Hydrazine preventive treatment. The overall percentage of positives remained stable over two years, at about 45% to 50%, but the individual’s response changed over time. Most of the patients with low initial IGRA also had their results below the cut-off during follow-up, with high initial IGRA results still positive, while IGRA had a moderate initial outcome and many dynamic types during follow-up. CONCLUSIONS: This study shows that the IGRA response varies significantly over time, suggesting limited utility in IGTV follow-up. However, in those individuals whose initial IGRA is a moderate result, they show different meanings of dynamic types that require further study.