《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (12): 1175-1178.

• 临床研究 • 上一篇    下一篇

活动性关节结核全血γ-干扰素检测结果分析

朱森1，黄迅悟2a，梁艳2b，彭伟2a，冯会成2a，张瑞斐1
   

  1. 1. 河北北方学院，河北张家口市075000；2. 解放军第309 医院，a.关节外科，b.结核研究所，北京市100091。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-12-25 发布日期:2014-12-25

Testing Result of Active Joint Tuberculosis's Whole Blood Interferon-γ Assay

ZHU Sen, HUANG Xun-wu, LIANG Yan, PENG Wei, FENG Hui-cheng, ZHANG Rui-fei.
  

  1. Department of Orthopedics, Hebei North University, Zhangjiakou, Hebei 075000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-12-25 Online:2014-12-25

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摘要： 目的探讨全血γ-干扰素(IFN-γ)检测在活动性关节结核诊断的意义。方法以5 种结核分枝杆菌特异性蛋白作为刺激蛋白，应用化学发光酶免疫分吸附法检测35 例活动性关节结核病患者及35 名健康体检者的全血IFN-γ含量，比较分析5 种蛋白刺激时对活动性关节结核检测的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比和阴性似然比，评估其诊断效能。结果CFP10/ESAT6 融合蛋白、Rv2041c 蛋白、Rv0057/1352 融合蛋白、Rv1419 蛋白及Rv1656 蛋白刺激时，全血IFN-γ检测灵敏性为77.1%、68.6%、71.4%、74.3%和65.7%，特异性为65.7%、54.3%、57.1%、60.0%和62.9%，阳性预测值为62.9%、60%、62.5%、65%及63.9%，阴性预测值为74.2%、63.3%、66.7%、70%及64.7%，阳性似然比为2.25、1.5、1.67、1.86 及1.77，阴性似然比为0.348、0.579、0.5、0.429 及0.545。结论全血IFN-γ检测对关节结核有一定参考意义，但不能作为活动性关节结核的确诊指标。

关键词: 关节结核, γ-干扰素, 诊断, 结核分枝杆菌, 特异性蛋白

Abstract: Objective To discuss the significance of the detection of interferon-γ in the diagnosis of active joint tuberculosis. Methods 5 kinds of specific proteins of mycobacterium tuberculosis were used as stimulating protein, the chemiluminescence enzyme immunoassay was used to test the content of interferon-γ. The interferon-γ of 35 cases of patients with active joint tuberculosis and 35 cases of healthy people were detected. The difference of the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of 5 kinds of proteins to the diagnostic of active joint tuberculosis were compared. Results CFP10/ESAT6 fusion protein, Rv2041c protein, Rv0057/1352 fusion proteins, Rv1419 protein and Rv1656 protein were used as stimulating protein, the sensitivities of active joint tuberculosis by the whole blood interferon-γ assay were 77.1%, 68.6%, 71.4%, 74.3 % and 65.7%. The specificities were 65.7%, 54.3%, 57.1%, 60.0% and 62.9%. The positive predictive values were 62.9%, 60%, 62.5%, 65% and 63.9%. The negative predictive values were 74.2%, 63.3%, 66.7%, 70% and 64.7%. The positive likelihood ratios were 2.25, 1.5, 1.67, 1.86 and 1.77. The negative likelihood ratios were 0.348, 0.579, 0.5, 0.429 and 0.545. Conclusion The detection of interferon-γ has certain significance to joint tuberculosis.
But it is not as an index of diagnosing joint tuberculosis.

Key words: joint tuberculosis, interferon-gamma, diagnosis, mycobacterium tuberculosis, specific proteins