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	结核分枝杆菌相关IFN-γ释放试验在结核病诊断及疗效监测中的应用; Application of Mycobacterium Tuberculosis Specific Protein InterferonGamma Release Assay in Tuberculosis Diagnosis and Therapeutic Monitoring
	张腊红 ; 洪理泉 ; 罗贤 ; 葛胜祥 ; 徐立群 ; 陈兆军
	2013-12-30
关键词	IFN-γ释放试验 结核 诊断 疗效 interferon-gamma release test mycobacterium tuberculosis diagnosis evaluation of clinical treatment
英文摘要	目的:目的:探讨结核分枝杆菌相关γ-干扰素释放试验(Tb-IgrA)在结核病诊断及临床抗结核治疗效果评价中的应用价值。方法:对196例临床确诊结核患者进行相关病史收集,同时进行Tb-IgrA、结核菌素皮肤试验、结核杆菌培养、涂片镜检、结核抗体检测,结核患者的治疗过程中按用药疗程(初治患者第2、5、6个月,复治患者第2、5、8个月)对其进行随访,在治疗结束后6个月和1年后各随访一次,比较Tb-IgrA与结核菌素皮肤试验在治疗过程中的变化。结果:确诊结核病例196例,其中肺结核158例,肺外结核38例,Tb-IgrA在结核诊断中灵敏度为82.1%,特异性为91.7%,阳性预测值为93.1%,阴性预测值为79.3%,与传统实验室检查方法相比有显著性差异(P<0.01)。在结核患者的抗结核治疗过程中,Tb-IgrA阳性率及浓度水平治疗前与治疗后2、6月以及复治后2、5、8月比较显著下降(P<0.01),Tb-IgrA水平与结核分枝杆菌数量存在较好相关性,与传统的TST方法评估疗效相比有显著性差异(P<0.01)。结论:Tb-IgrA在结核诊断中敏感性和阳性预测值较高,可作为较好的结核诊断的依据,同时Tb-IgrA对肺外结核的灵敏度较高,为肺外结核患者的诊断提供了较为可靠的依据,通过治疗过程Tb-IgrA检测分析,外周血Tb-IgrA的变化随着抗结核治疗的进程下降的趋势明显,与结核涂片镜检结果符合率较高,是临床疗效评估较为理想的指标。; Objective To investigate the applicative value of mycobacterium tuberculosis specific protein interferon gamma release test in early diagnosis of tuberculosis and the evaluation of clinical efficacy.Methods 196 clinical diagnosis of tuberculosis patients were related to the history collection,and detected by TB-IGRA simueltaneously,tuberculin skin test( purified protein derivative of tuberculin 5 units),tubercle bacillus culture,directly smear,tuberculosis antibody detection.Treatment of tuberculosis patients were followed up( 2,5,6 months,retreatment patients at 2,5,8 months),in 6 months and 1 years after the end of treatment followup once.Compared with difference between the IGRA and tuberculin skin test and other traditional laboratory results.Results Confirmed tuberculosis cases in 196 cases,including 158 cases of pulmonary tuberculosis,38 cases of extra-pulmonary tuberculosis.The sensitivity of TB-IGRA in the pulmonary tuberculosis and extra-pulmonary tuberculosis showed 81% and 86.8% respectively,at the same time,TB-IGRA in the diagnosis of tuberculosis,the negative predictive value express 86.3%,specificity was 91.7%,and the positive predictive value was 88.2%.In anti-tuberculosis treatment the positive rate of TB-IGRA and concentration levels before treatment and after treatment 2,5,6months,retreatment 2,5,8months decreased significantly( P < 0.01).There is better correlation TB-IGRA concentration level with number of mycobacterium tuberculosis.It is significant difference compared to TB-IGRA with the traditional TST method to the evaluation of clinical treatment( P < 0.01).Conclusion The sensitivity of TB-IGRA in the diagnosis of tuberculosis and the postive predictive value is higher; it can be used as a good basis for the diagnosis of tuberculosis.TB-IGRA provides a more reliable diagnosis method in patients with extra-pulmonary tuberculosis.Peripheral blood TB-IGRA decreased significantly in anti- tuberculosis treatment process.Coincidence rate between TB-IGRA concentration level and number of mycobacterium tuberculosis is higher.It is an ideal index to evaluate the clinical efficacy.; 浙江省医药卫生科技计划项目(2009A167)
语种	zh_CN
内容类型	期刊论文
源URL	[http://dspace.xmu.edu.cn/handle/2288/124984]
专题	公共卫生－已发表论文
推荐引用方式 GB/T 7714	张腊红,洪理泉,罗贤,等. 结核分枝杆菌相关IFN-γ释放试验在结核病诊断及疗效监测中的应用, Application of Mycobacterium Tuberculosis Specific Protein InterferonGamma Release Assay in Tuberculosis Diagnosis and Therapeutic Monitoring[J],2013.
APA	张腊红,洪理泉,罗贤,葛胜祥,徐立群,&陈兆军.(2013).结核分枝杆菌相关IFN-γ释放试验在结核病诊断及疗效监测中的应用..
MLA	张腊红,et al."结核分枝杆菌相关IFN-γ释放试验在结核病诊断及疗效监测中的应用".(2013).

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