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目的:探讨γ干扰素释放试验(IGRA)对高危患者肺结核(PTB)的诊断价值。方法:选择入住我院经全血IGRA T细胞斑点试验(T-SPOT.TB)检测结果明确的患者209例,其中,确诊为活动性结核(ATB组)155例、排除结核(非TB组)11例,未明确诊断(诊断不明确组)43例。按照相关标准,对全血IGRA T-SPOT.TB检测结果进行判读。结果:ATB组T-SPOT.TB检测的阳性率82.6%(128/155),非常显著高于非TB组的9.1%(1/11)(P<0.01)。T-SPOT.TB检测在高危患者群(ATB组)中诊断PTB的敏感度为82.6%(128/155),特异性为90.9%(10/11)。T-SPOT.TB检测结果明确209例中,阳性151例,阳性预测值84.8%(128/151);阴性39例,阴性预测值25.6%(10/39)。结论:IGRA T-SPOT.TB检测对高危患者PTB诊断具有较高的灵敏度和特异性,且阳性结果具有较高的支持诊断价值,阴性结果需谨慎排除诊断。
Objective: To investigate the value of interferon gamma release (IGRA) in the diagnosis of pulmonary tuberculosis (PTB) in high-risk patients. Methods: A total of 209 patients with definite test results of T-SPOT.TB were enrolled in our hospital. Among them, 155 cases were diagnosed as active tuberculosis (ATB group) and TB (excluding TB group) 11 cases, not clear diagnosis (diagnosis is not clear group) 43 cases. According to the relevant standards, interpretation of whole blood IGRA T-SPOT.TB test results. Results: The positive rate of T-SPOT.TB in ATB group was 82.6% (128/155), which was significantly higher than 9.1% (1/11) in non-TB group (P <0.01). The sensitivity and specificity of T-SPOT.TB for the diagnosis of PTB in high-risk patients (ATB group) were 82.6% (128/155) and 90.9% (10/11) respectively. T-SPOT.TB test results clear 209 cases were positive 151 cases, the positive predictive value of 84.8% (128/151); negative 39 cases, negative predictive value of 25.6% (10/39). Conclusions: IGRA T-SPOT.TB test has high sensitivity and specificity for PTB diagnosis in high-risk patients, and the positive results have high supportive diagnosis value. Negative results should be carefully excluded from diagnosis.