【摘要】 目的评价全血γ干扰素释放试验在活动性肺结核诊断中的应用价值。方法应用一种全血γ干扰素释放检测试剂盒QuantiFERON-TB gold in tube(QFT-GIT)对48例活动性肺结核患者(活动性结核组)进行检测,同时选取55例健康者作为对照(对照组),均通过调查问卷排除结核病接触史。结果本研究活动性结核组患者和对照组QFT-GIT阳性率分别为93.8%和11.1%,QFT-GIT诊断活动性肺结核的总体敏感性和特异性分别为93.8%和88.9%,阳性和阴性预测值分别为88.2%和94.1%。活动性结核组抗原特异性T细胞应答率显著高于对照组(P<0.0001)。随着抗结核化疗疗程的延长,活动性结核组中的抗原特异性T细胞释放的γ干扰素水平逐步下降(P<0.05)。结论 QFT-GIT用于诊断活动性肺结核具有较高的敏感性和特异性,其结果不受卡介苗接种的影响,具有较高的临床应用价值。更多还原

【Abstract】 Objective To evaluate the application of whole blood interferon-γ release assay QuantiFERON-TB gold in tube ( QFT-GIT) on the diagnosis of active pulmonary tuberculosis in China. Methods With the commercial whole blood interferon-γ QFT-GIT kit,interferon-γ released by specific T cells stimulated under early secreted antigenic target 6 kD protein ( ESAT-6 ) ,culture filtrate protein 10 ( CFP-10) and TB7. 7 were measured among 48 cases with active pulmonary tuberculosis and 55 BCG ( bacillus calmette-guérin) -vaccinated healthy controls, who had no tuberculosis contact history by questionnaire. Results The QFT-GIT was positive in 93. 8% patients with active pulmonary tuberculosis and 11. 1% healthy controls,respectively. The sensitivity,specificity,positive predictive value and negative predictive value of QFT-GIT were 93. 8% ,88. 9% ,88. 2% and 94. 1% ,respectively. The antigen-specific IFN-γ release was significantly higher in patients with active pulmonary tuberculosis in comparison with that in the controls ( P < 0. 0001) . Furthermore,after anti-tuberculosis treatment,the antigen-specific IFN-γ decreased significantly ( P < 0. 05) . Conclusions QFT-GIT is a sensitive and specific assay for detecting tuberculosis,which could discriminate the active tuberculosis patients from BCG vaccinated healthy controls and could be a convenient and useful diagnostic tool for the diagnosis of tuberculosis.更多还原