
γ干扰素释放试验在儿童肺结核诊断中的价值
Performance of interferon γ release assays in diagnosis of childhood pulmonary tuberculosis
为研究2种γ干扰素释放试验(IGRA)试剂盒在结核病高发、卡介苗(BCG)高接种地区用于诊断儿童肺结核的价值,共入组临床怀疑肺结核患儿114例,其中45例行QuantiFERON-Gold In-Tube(QFT-GIT)检测,69例行T-SPOT.TB检测,收集临床资料进行诊断,比较2种方法的灵敏度、特异度、阳性预测值(PPV)和阴性预测值(NPV)。结果显示,QFT-GIT在儿童肺结核诊断中的灵敏度为86.4%、特异度为81.3%、PPV为91.7%、NPV为76.5%。T-SPOT.TB的灵敏度为72.3%、特异度为93.7%、PPV为97.1%、NPV为53.6%。与未治疗患者相比,激素治疗患者QFT-GIT和T-SPOT.TB的阳性率显著下降。研究提示,QFT-GIT和T-SPOT.TB较少受潜伏性感染的影响,用于中国儿童肺结核的诊断具有较高的PPV。
In order to investigate the performance of two kinds of interferon γ release assays in the diagnosis of childhood pulmonary tuberculosis in China (with a high rate of bacillus Calmette-Guérin vaccination and a high incidence of tuberculosis), a total of 114 children with suspected pulmonary tuberculosis were recruited. Among the cases, 45 received QuantiFERON-Gold In-Tube (QFT-GIT) test while the other 69 were tested with T-SPOT.TB. The clinical information was collected for diagnostic classification. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared between the two methods. The sensitivity of QFT-GIT in the diagnosis of childhood pulmonary tuberculosis was 86.4%, the specificity was 81.3%, PPV was 91.7%, and NPV was 76.5%. In contrast, the sensitivity of T-SPOT.TB was72.3%, the specificity was 93.7%, PPV was 97.1%, and NPV was 53.6%. The positive rates of two methods in the cases treated with glucocorticoids decreased significantly compared to those untreated. In conclusion, both QFT-GIT and T-SPOT.TB have high PPV in the diagnosis of childhood pulmonary tuberculosis since the rate of latent tuberculosis infection was low in children.
Child / Pulmonary tuberculosis / Interferon &gamma / release assays
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