Objective: To investigate the value of interferon gamma release (IGRA) in the diagnosis of bacterial-negative pulmonary tuberculosis. Methods: A total of 93 patients with bacterial-negative tuberculosis and 40 healthy volunteers were enrolled in this study. Heparin sodium anticoagulant whole blood was collected. IGRA kit was used to detect the plasma IFN-γ level. Serum samples were collected for detection of Mycobacterium tuberculosis antibody(TBAb) by ELISA kit. Patients were divided into the elderly group and the young group for comparative analysis. Routine test indice ADA, erythrocyte sedimentation rate and lymphocyte count were performed. Results: The positive rate of IGRA was 84.94%, the sensitivity was 84.94%, the specificity was 90.00%, the positive predictive value was 95.18% and the negative predictive value was 72.00%. The positive rate of TBAb diagnosis was 52.69%, the sensitivity was 52.69%, the specificity was 85.00%, the positive predictive value was 67.20% and the negative predictive value was 40.96%. Rate of diagnosing tuberculosis using two methods, was statistically significant. There was no difference in age when using IGRA assays. There was significant differences in erythrocyte sedimentation rate between the two groups. Conclusion: Compared with ELISA, IGRA has higher sensitivity, specificity and positive predictive for diagnosing bacterium negative tuberculosis.
HE Meifang, LIU Jianhong, CHEN Chunhua, SHEN Hongyu
. Comparison and application of whole blood interferon-gamma release assays and ELISA for detection of antibodies against Mycobacterium tuberculosis in auxiliary diagnosis of bacterium-negative pulmonary tuberculosis[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(05)
: 586
-589
.
DOI: 10.16150/j.1671-2870.2018.05.020
[1] Liu MY, Li QH, Zhang YJ, et al.Spatial and temporal clustering analysis of tuberculosis in the mainland of China at the prefecture level, 2005-2015[J]. Infect Dis Poverty,2018,7(1):106.
[2] 全国第五次结核病流行病学抽样调查技术指导组,全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告[J]. 中国防痨杂志,2012,34(8):485-508.
[3] 李琦. 菌阴肺结核诊断现状及展望[J]. 结核病健康教育,2008,17(2):9-12.
[4] 栗方芝, 李娜娜, 石亚萍, 等. 两种IGRA 检测方法诊断结核分枝杆菌潜伏感染的效能分析[J]. 中外健康文摘,2014,11(1):26-27.
[5] Diel R, Loddenkemper R, Nienhaus A.Evidence-based comparison of commercial interferon-gamma release assays for detecting active TB: a metaanalysis[J]. Chest,2010,137(4):952-968.
[6] Lalvani A.Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy[J]. Chest,2007,131(6):1898-1906.
[7] Qian F, Wang W, Qiu Z, et al.Evaluation of a new tuberculosis-related interferon gamma release assay for tuberculosis infection diagnosis in Huzhou, eastern China[J]. Indian J Pathol Microbiol,2013,56(2):125-128.
[8] 王卫, 肖和平, 李红, 等. 两种γ-干扰素释放试验方法在结核病诊断中的应用价值比较[J]. 中国防痨杂志,2015,37(7):768-773.
[9] 张怡, 谢晓丹. 全血γ-干扰素释放试验在结核诊断中的应用价值[J]. 生物技术通讯,2016,27(2):260-262.
[10] 闫鹏, 任飞霏, 苏龙翔, 等. 国产外周全血γ干扰素实验对肺结核病的诊断价值[J]. 解放军医学院学报,2015,36(3):258-261.
[11] 潘丽萍, 贾红彦, 刘菲, 等. γ干扰素释放试验对不同年龄组疑似肺结核的辅助诊断价值[J]. 中华结核和呼吸杂志,2015,38(12):892-896.
[12] 孟苏凯,吴振萍,钟达. 全血γ-干扰素释放试验在诊断结核分枝杆菌感染中的应用价值[J]. 中国防痨杂志,2015,37(12):1217-1220.
[13] 邹琳琳,黎友伦. γ干扰素释放试验在免疫受损合并肺结核患者中的应用[J]. 中国免疫学杂志,2016,32(6):878-881.
[14] 中华人民共和国国家卫生和计划生育委员. 肺结核诊断[S]. 中华人民共和国卫生行业标准,WS288-2017.
