γ-干扰素释放试验在尘肺病合并结核患者早期诊断中的价值

摘要

目的 探讨γ-干扰素释放试验(IGRAs)在尘肺病合并结核患者早期诊断中的价值.方法 采用回顾性分析的方法对2016年1月至2017年12月在我院就诊的498例尘肺病患者γ-干扰素释放试验的检测结果进行统计分析,并与1176例非尘肺病患者γ-干扰素释放试验的检测结果进行对比. 结果 在有呼吸道感染症状的患者中,尘肺病γ-干扰素释放试验的阳性率为33.73％,非尘肺病为23.64％,尘肺病患者明显高于非尘肺病患者(x 2=18.24,P＜0.0001).在临床诊断结核痰菌阳性的尘肺病患者中,γ-干扰素释放试验阳性率为95.35％,在临床诊断结核痰菌阴性的尘肺病患者中,γ-干扰素释放试验阳性率为89.13％(x2 =0.48,P=0.49).在尘肺病的各期别中,Ⅱ期尘肺病和Ⅲ期尘肺病患者,γ-干扰素释放试验阳性率高于Ⅰ期尘肺病患者,并且随着尘肺病的进展呈上升趋势(x2=2.21,P=0.023). 结论 γ-干扰素释放试验在尘肺病合并结核的早期诊断中具有重要的辅助诊断价值.%Objective To investigate the value of interferon-γ release assays(IGRAs)in early diagnosis of pneumoconiosis complicated with tuberculosis.Methods The retrospective study analyzed the results of IGRAs of 498 patients with pneumoconiosis at our hospital from January 2016 to December 2017.The results were compared with those of 1176 non-pneumoconiosis patients.Results The rate of positive IGRAs in patients with pneumoconiosis who had symptoms of respiratory infection was 33.73％,significantly higher than that in non-pneumoconiosis patients (23.64％)(x2 =18.24,P＜0.0001).In pneumoconiosis patients with tuberculosis,the rate of positive IGRAs was 95.35 ％,and in pneumoconiosis patients without tuberculosis,the rate was 89.13 ％ (x2=0.48,P=0.49).The rates of positive IGRAs in patients with stage Ⅱ and stage Ⅲ pneumoconiosis were significantly higher than those in the patients with stage Ⅰ pneumoconiosis,and they increased with the progression of pneumoconiosis (x2 =2.21,P =0.023).Conclusions IGRAs offer added diagnostic value in early diagnosis of pneumoconiosis complicated with tuberculosis.