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目的探讨在结核病高发的新疆喀什地区,应用全血IFN-γ干扰素释放试验(TB-IGRA)诊断结核病的应用价值。方法采用回顾性分析方法,对结核病病人635例、非结核感染病人748例,以及30名健康体检者,分别进行TB-IGRA(ELISA法)试验、血清结核杆菌抗体(胶体金法)及痰涂片检查,并对检测结果进行统计分析。结果 TB-IGRA试验诊断结核病特异性90.5%、敏感性81.9%,均高于其他2种结核病检测方法;阳性检出率中肺结核病为81.0%、肺外结核病83.8%、结核菌阴性肺结核病86.5%;阳性预测值为87.5%、阴性预测值为85.9%。结论在喀什地区TB-IGRA试验对结核病的诊断有较高的敏感性和特异性,对难以诊断的肺外结核病和结核菌阴性肺结核病也有较高的阳性检出率,临床应用价值较大。
Objective To investigate the value of TB-IGRA in the diagnosis of tuberculosis in Xinjiang Kashgar with high incidence of tuberculosis. Methods A total of 635 TB patients, 748 non-TB patients and 30 healthy controls were enrolled in this study. TB-IGRA (ELISA), Mycobacterium tuberculosis (AgC) and sputum Film inspection, and statistical analysis of test results. Results The specificity of TB-IGRA was 90.5% and the sensitivity was 81.9%. TB-IGRA was higher than the other two kinds of tuberculosis detection methods. The positive detection rate was 81.0% for tuberculosis, 83.8% for extrapulmonary tuberculosis, 86.5 for tuberculosis-negative tuberculosis %; Positive predictive value was 87.5%, negative predictive value was 85.9%. Conclusion The TB-IGRA test in Kashgar region has a high sensitivity and specificity for the diagnosis of tuberculosis. It also has a high positive detection rate for tuberculosis and tuberculosis-negative pulmonary tuberculosis that are difficult to diagnose and has great clinical value.