干扰素体外释放酶联免疫法在结核潜伏感染诊断中的价值

摘要

目的 探讨干扰素体外释放酶联免疫法(TB-IGRA)在诊断诊断结核分枝杆菌潜伏感染的价值.方法 分枝杆菌相关γ-干扰素检测试剂盒(WT- IGRA)检测140例健康者IFN-γ分泌水平,并对其进行结核菌素皮试及采用Cellestis Limited 生产的QuantiFERON-TB试剂盒进行IFN-γ平行检测.结果 140例健康者中,WT试剂和QFT试剂阳性率分别是25.7%(36/140)、21.4%(30/140),PPD3+～4+为14.3%(20/140).两试剂阳性符合率为81.3%,阴性符合率为88.9%,总符合率86.7%.28例密接者中,PPD3+～4+为39.3%(11/28),WT试剂和QFT试剂阳性率分别是46.4%(13/28)和67.8%(19/28).结论 TB-IGRA在诊断结核分枝杆菌潜伏感染的价值优于PPD皮试,可以用于潜伏感染者的筛查.%Objective To investigate the clinical value of the Quantitative Diagnostic Kit for Mycobacterium tuberculosis-IFN-γrelease assay( TB-IGRA ) in diagnosing latent Mycobaterium tuberculosis infection. Methods 140 subjects were analyzed; antigen spe-cific-IFN response were determined by using regents from two suppliers, Quantitative Diagnostic Kit for Mycobacterium tuberculosis-IFN-γ release assay( WT-IGRA ) and QuantiFERON?-TB GOLD in tube ( QFT-GIT, Cellestis Limited, Australia ). Subjects received PPD skin test as well. Results Among 140 subjects,the positive rates of TB-IGRA with WT and QFT-G were 25. 7( 36/1404 ),21. 4%( 30/140 ), PPD3 H+~4 + was 14. 3%( 20/140 ). The positive consistency of two kits was81. 3% , negative consistency was 88. 9% , total consistency was 86.1%. Among 28 close contacts, their PPD3 + ~4+was 39. 3%( 11/28 ),WT and QFT positive rates were 46. 4%( 13/28 ) and 67. 8%( 19/28 ). Conclusions The diagnostic value of latent Mtb infection of TB-IGRA is higher than that of PPD method, TB-IGRA can be used as a screening method for latent Mtb infection patients.