全血结核菌特异性干扰素—γ定量检测在从肺部-中国病原生物学杂志.DOC

结核感染T细胞免疫 熊晓顺，刘彩霞，杨锦红，李向阳 温州医科大学附属第二医院，浙江 温州 325027 摘要：目的 评估结核感染T细胞免疫检测（IGRA/ELISA106例，根据结核诊断标准确诊30例为结核感染，76例为非结核感染。用IGRA/ELISA法检测患者血液中经结核特异性抗原刺激后的淋巴细胞释放的IFN-γ含量，比较两组IFN-γ含量的差异；绘制ROC曲线并分析AUC和最佳截断值及最佳界点处的敏感度、特异度和约登指数。结果 结核组IFN-γ浓度均值为（329.72±31.03）?pg/ml，非肺结核组为（52.77±12.08）?pg/ml，t=8.318，P=0.000ROC曲线下面积AUC=0.934（95%CI，0.890～0.978），当界点为59.7?pg/ml，灵敏度为100%，特异度为78.9%，约登指数为0.789（约登指数最大值）；当界点为108.25?pg/ml，灵敏度为90%，特异度为84.2%，约登指数为0.742；当界点为404?pg/ml时，灵敏度为33.3%，特异度100%，0.333。IGRA/ELISA法检测IFN-59.7?pg/ml，108.25?pg，404?pg/ml三个界点辅助临床对肺部感染鉴别诊断结核病有较好应用价值。 关键词：结核感染T细胞免疫检测；诊断效能 The application of IGRA/ELISA in the differential diagnosis of pulmonary infection XIONG Xiao-shun LI Fang-qv YANG Jin-Hong LI Xiang-yang，Department of laboratory medicine， the Second affiliated hospital of Wenzhou Medical University. Wenzhou 325000 Zhejiang Province, China Corresponding author: LI Xiang-yang，Department of laboratory medicine, the Second affiliated hospital of Wenzhou Medical University. 325027. 【Abstract】 Objective to assess the value of IGRA/ELISA(Interferon-γ release assay/Enzyme-linked immunosorbent assay) for differential diagnosis of tuberculosis in patients with pulmonary infection. Methods According to the TB diagnostic criteria, 106 cases with lung infection were divided into two groups: TB infection group (30 cases), non-tuberculosis infection group (76 cases). IGRA/ELISA was used to detect the content of interferon-γ(IFN-γ) released by lymphocytes stimulated with TB-specific antigens in the blood of patients. Then compare the differences of IFN-γ content between the two groups, Draw the receiver operation curve (ROC), analysis area under the curve (AUC) Of ROC and the best cut-off value and its sensitivity, specificity, Youden Index. Results IFN-γ average content of TB group was( 329.72 ± 31.03)?pg/ml, that of non-pulmonary tuberculosis group was (52.77 ± 12.08)?pg/ml, t=8.318 P=0.000 AUC=0.934 (95%CI,0.890-0.978), when the cut-off point was 59.