CAJ | 학술논문

目的：探讨全血γ干扰素释放试验在结核病中的诊断价值。方法对92例拟诊结核病例和22例非结核阴性对照病例进行全血γ干扰素释放试验，同时将92例拟诊病例根据其结核诊断依据强度分为可能结核病例组（17例）、疑似结核病组（58例）和确诊结核病例组（20例）3组，观察各组病例γ干扰素释放试验阳性率。结果92例拟诊结核病例中，阳性73例，总体阳性率为79.34％。其中可能病例、疑似病例和确诊病例组阳性率分别为38.89％（7/17）、87.27％（48/55）、90.06％（18/20）；22例阴性对照组中仅1例阳性，特异性为95.45％（21/22）。所有14岁以下拟诊儿童病例阳性率为57.14％（4/7），明显低于总体阳性率和成人阳性率。在确诊和疑似结核病例的9例阴性结果中，包括2例儿童，1例高龄患者，1例合并2型糖尿病，1例 HIV 抗体阳性。结论全血γ干扰素释放试验是一种敏感性和特异性均较高的结核病诊断方法，对肺及肺外结核病的诊断和鉴别诊断有重要的应用价值。同时，患者免疫状况和基础疾病（如 HIV 感染、糖尿病等）对γ干扰素释放试验结果存在一定影响。
목적：탐토전혈γ간우소석방시험재결핵병중적진단개치。방법대92례의진결핵병례화22례비결핵음성대조병례진행전혈γ간우소석방시험，동시장92례의진병례근거기결핵진단의거강도분위가능결핵병례조（17례）、의사결핵병조（58례）화학진결핵병례조（20례）3조，관찰각조병례γ간우소석방시험양성솔。결과92례의진결핵병례중，양성73례，총체양성솔위79.34％。기중가능병례、의사병례화학진병례조양성솔분별위38.89％（7/17）、87.27％（48/55）、90.06％（18/20）；22례음성대조조중부1례양성，특이성위95.45％（21/22）。소유14세이하의진인동병례양성솔위57.14％（4/7），명현저우총체양성솔화성인양성솔。재학진화의사결핵병례적9례음성결과중，포괄2례인동，1례고령환자，1례합병2형당뇨병，1례 HIV 항체양성。결론전혈γ간우소석방시험시일충민감성화특이성균교고적결핵병진단방법，대폐급폐외결핵병적진단화감별진단유중요적응용개치。동시，환자면역상황화기출질병（여 HIV 감염、당뇨병등）대γ간우소석방시험결과존재일정영향。
Objective To investigate the diagnostic value of blood interferon gamma release assays(IGRAs)for tuberculosis. Methods 92 suspected cases with tuberculosis and 22 non-tuberculosis control cases were selected and they all received IGRAs;according to the diagnostic basis congruence,the 92 suspected cases were divided into 3 groups:possible TB group(n = 17),suspected TB group(n = 55)and confirmed TB group(n = 20);the positive rate of IGRAs in each group was observed. Results Out of the 92 cases,73 cases were positive in IGRAs,the positive rate was 79. 34% ,while the positive rates in possible TB group,suspected TB group and confirmed TB group were 38. 89%(7 / 17),87. 27%(48 / 55)and 90. 06%(18 / 20),respectively;only 1 case was positive out of the 22 control cases,the specificity was 95. 45% (21 / 22);the positive rate in children under 14 years was 57. 14% (4 / 7), significantly lower than the total positive rate;out of the suspected and confirmed cases,9 cases were negative in IGRAs,including 2 children,1 senile patient,1 case with type 2 diabetes and 1 case with HIV infection. Conclusions IGRAs is sensitive and specific in diagnosing TB and it is of important application value in diagnosis and differential diagnosis of pulmonary and extra pulmonary tuberculosis;immune status of the patients and basic diseases such as HIV infection and diabetes are of certain interference with the results of IGRAs.