[1]张培莉a,刘义庆a,邵 婧a,等.结核感染T淋巴细胞IFN-γ释放实验临床检测分析[J].现代检验医学杂志,2017,32(01):22-25,29.[doi:10.3969/j.issn.1671-7414.2017.01.007]
　ZHANG Pei-lia,LIU Yi-qinga,SHAO Jinga,et al.Interferon Gamma Release Assays from T Lymphocytes in Patients with Tuberculosis Infection[J].Journal of Modern Laboratory Medicine,2017,32(01):22-25,29.[doi:10.3969/j.issn.1671-7414.2017.01.007]
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结核感染T淋巴细胞IFN-γ释放实验临床检测分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年01期
页码:
22-25,29
栏目:
论著
出版日期:
2017-01-25

文章信息/Info

Title:
Interferon Gamma Release Assays from T Lymphocytes in Patients with Tuberculosis Infection
文章编号:
1671-7414(2017)01-022-05
作者:
张培莉a; 刘义庆a; 邵 婧a; 陈兰兰a; 牛登冉a; 段文冰a; 张 栋b
山东大学附属省立医院a.临床医学检验部;
b.泌尿外科,济南 250021
Author(s):
ZHANG Pei-lia; LIU Yi-qinga; SHAO Jinga; CHEN Lan-lana; NIU Deng-rana; DUAN Wen-bingb;  ZHANG Dong2
a.Department of Clinical Laboratory;
b.Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China
关键词:
γ干扰素释放试验;  结核;  T 淋巴细胞;  实验室技术和方法
分类号:
R378.911; R446.61
DOI:
10.3969/j.issn.1671-7414.2017.01.007
文献标志码:
A
摘要:
目的 探讨结核感染T淋巴细胞γ干扰素释放试验(IGRAs)在临床检测结核病中的应用价值。方法 利用IGRAs方法检测2013～2016年11 968例门诊及住院结核筛查患者。按科室分布分析,同时对检测阳性病例按性别、年龄进行分析比较,并对不确定结果进行分析。另外对不同方法检测结核杆菌感染情况进行比较。结果 11 968例筛查者中,2 048例阳性,阳性率为17.11%,不确定结果107例,占总检测数的0.89%。2013～2016年检测阳性率分别为19.65%,21.35%,15.82%和13.56%。肺内及肺外结核检测筛查中,呼吸科、消化科、肿瘤科、神经科和妇科阳性率分别为22.07%,20.27%,23.38%,12.84%和11.86%。阳性筛查者中,男性占62.11%,女性占37.89%,男性明显高于女性。按年龄分组,≤15,16～25,26～45,46～65和≥66岁,各年龄段阳性率分别为1.96%,18.51%,16.54%,21.25%和25.73%。分析不确定结果数据,风湿免疫科、血液科比例最高,分别占1.99%和2.35%。与其它实验室检测方法对比,IGRAs方法具有明显优势。结论 结核好发于全身各个器官,结核菌感染存在性别、年龄差异。IGRAs是灵敏和特异的快速检测结核分枝杆菌感染的方法,虽不能作为确诊指标,但为进一步确诊疾病,在结核疑似患者筛查中具有较大临床应用价值。
Abstract:
Objective To explore the application value of interferon gamma release assay(IGRAs)in the clinical detection of tuberculosisinfected T lymphocytes.Methods Used IGRAs method to detect the 11 968 outpatients and hospitalized patients from 2013 to 2016 with tuberculosis screening.According to the distribution department analysis,also ofpositive case detection according to age and gender were analysis and comparison and analysis on the uncertainty of results,different methods were compared.Results Among the 11 968 cases,2 048 cases were positive,the positive rate was 17.11%,and the uncertain result was 107 cases,which accounted for 0.89% of the total number.The positive rates from 2013 to 2016 were 19.65%,21.35%,15.82% and 13.56%,respectively.In the detection and screening of pulmonary and pulmonary tuberculosis,the positive rates of the departmentof respiration,the digestive department,the oncology department,the department of neurology and the department of gynecology were 22.07%,20.27%,23.38%,12.84% and 11.86%,respectively.In the positive screening,men accounted for 62.11%,women accounted for 37.89%,men were significantly higher than women.By age group,was less than or equal to 15,16～25,26～45,46～65,was more than orequal to 66 years old,positive rate were 1.96%,18.51%,16.54%,21.25% and 25.73%,respectively.Analysis of uncertain outcome data,departmentof respiration,rheumatism,department of hematology,accounted for 1.99% and 2.35%,respectively.Compared with other laboratory methods,the IGRAs method had obvious advantages.Conclusion Tuberculosis occurs in various body organs,there were differences in gender and age of Mycobacterium tuberculosis infection.IGRAs is a sensitive and specific method for rapid detection of Mycobacterium tuberculosis infection,although it can not be used as a diagnostic indicator,but in patients with suspected tuberculosis IGRAs has a larger clinicalapplication value for the further diagnosis of disease.

参考文献/References:

[1] Sharma SK,Mohanan S,Sharma A.Revelance of latent TB infection in areas of high TB prevalence[J].Chest,2012,142(3):761-773.
[2] Andersen P,Munk ME,Pollock JM,et al.Specific immune-based diagnosisof tuberculosis[J].Lancet,2000,356(9235):1099-1104.
[3] Zhang S,Shao L,Mo L,et al.Evaluation of gamma interferon release assays using Mycobacterium tuberculosis antigens for diagnosis of latent and active tuberculosis in Mycobacterium bovis BCG-vaccinated populations[J].Clin Vaccine lmmunol,2010,17(12):1985-1990.
[4] 刘 斌,殷水泽,马世武,等.全血γ干扰素释放试验在拟诊结核患者中的应用价值[J].西南国防医药,2014,24(7):721-723. Liu B,Yin SZ,Ma SW,et al.Application value of interferon gamma release assaysin suspected cases with tuberculosis[J].Medical Journal of National Defending Forces in Southwest China,2014,24(7):721-723.
[5] 黄 翔,陈 晋.结核性胸腔积液的实验室诊断研究进展[J].现代检验医学杂志,2014,29(1):97-100. Huang X,Chen J.Laboratory diagnosis of tuberculous pleural effusion[J].J Mod Lab Med,2014,29(1):97-100.
[6] 杨华夏,张丽帆,刘晓清,等.风湿性疾病的T细胞γ干扰素释放分析诊断潜伏性结核分枝杆菌感染[J].中华临床免疫和变态反应杂志,2011,5(2):83-87. Yang HX,Zhang LF,Liu XQ,et al.T-cell interferon-gamma releaseassays to detect latent tuberculosis infection in rheumatic diseases[J].Chinese Journal of Allergy Clinical & Immunology,2011,5(2):83-87.
[7] Erdozain JG,Ruiz-Irastorza G,Egurbide MA,et al.High risk of tuberculosis in systemic lupus erythematosus?[J].Lupus,2006,15(4):232-235.
[8] Hauck FR,Neese BH,Panchal AS,et al.Identification and management of latent tuberculosis infection[J].Am Fam Physician,2009,79(10):879-886.
[9] 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. Technical Guidance Group of the Fifth National TB Epidemiologico Survey,The Office of the Fifth National TB Epidemiological Survey.The fifth national tuberculosis epidemiological survey in 2010[J].Chinese Journal of Antituberculosis,2012,34(8):485-508.
[10] 张 弛,吴俊英,杨倩婷,等.深圳市2013年门诊结核病人流行病学调查分析[J].临床肺科杂志,2015,20(9):1560-1563. Zhang C,Wu JY,Yang QT,et al.Investigation on epidemiology of outpatient with tuberculosis in Shenzhen[J].Journal of Clinical Pulmonary Medicine,2015,20(9):1560-1563.
[11] 王秀丽,张乐平,汪远红.抗结核药物治疗老年肺结核患者的不良反应及防治方法[J].中国医药,2013,5(3):223-224. Wang XL,Zhang LP,Wang YH.Analysis and prevention of adverse reaction ofanti-tuberculosis drugs in elderly patients[J].China Medicine,2013,5(3):223-224.
[12] Amanatidou V,Syridou G,Mavrikou M,et al.Latent tuberculosis infection in children:diagnostic approaches[J].Eur J Clin Microbiol Infect Dis,2012,31(7):1285-1294.
[13] Matulis G,Juni P,Villiger PM,et al.Detection of latent tuberculosisin immunosuppressed patients with autoimmune diseases:performance of aMycobacterium tuberculosis antigen-specific interferon gamma assay[J].Ann RheumDis,2008,67(1):84-90.
[14] Bocchino M,Matarese A,Bellofiore B,et al.Perfor-mance of two commercial blood IFN-gamma release assays for the detection of Mycobacterium tuberculosis infection in patient candidates for anti-TNF-alpha treatment[J].EurJ Clin Microbiol Infect Dis,2008,27(10):907-913.
[15] 王铁山,齐墨词.比较四种实验室辅助检查方法在肺结核诊断中的应用价值[J].现代检验医学杂志,2016,31(1):134-137. Wang TS,Qi MC.A comparative study on four me-thods in the diagnosis of tuberoulosis[J].J Mod Lab Med,2016,31(1):134-137.

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备注/Memo

备注/Memo:
基金项目:山东省自然科学基金(ZR2016HM52); 山东省科学技术发展计划资助项目(2014GGH218041); 山东省临床重点专科项目(鲁卫医字[2013]26号)。
作者简介:张培莉(1987-),女,本科,技师,主要从事免疫学检验工作,Tel:15168863575,E-mail:zpl117@126.com。
通讯作者:刘义庆,E-mail:yqliu1979@163.com。
更新日期/Last Update: 2017-01-20