γ-干扰素释放试验对儿童结核性脑膜炎的诊断价值

doi:10.3969j.issn.1000-3606.2015.03.011

临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (3): 242-.doi: 10.3969j.issn.1000-3606.2015.03.011

γ-干扰素释放试验对儿童结核性脑膜炎的诊断价值

母发光¹,何海兰¹,谭泰昌²,李毅³

1.四川省医学科学院　四川省人民医院儿科(四川成都　610072)；2.四川省医学科学院四川省人民医院免疫室(四川成都　610072)；3.四川省阿坝州人民医院儿科 (四川马尔康　624000)

收稿日期:2015-03-15 出版日期:2015-03-15 发布日期:2015-03-15
通讯作者: 母发光 E-mail:mufaguang@163.com

The value of interferon gamma release assays in the diagnosis of tuberculous meningitis in children

MU Faguang¹, HE Hailan¹, TAN Taichang², LI Yi³

1. Department of Pediatrics, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China; 2. Laboratory of Immunology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China; 3. Department of Pediatrics, People's Hospital of Aba Prefecture of Sichuan Province, Barkam 624000, Sichuan, China

Received:2015-03-15 Online:2015-03-15 Published:2015-03-15

摘要/Abstract

摘要： 目的　探讨γ-干扰素释放试验(IGRAs)对儿童结核性脑膜炎的诊断价值。方法　采用前瞻性病例对照研究方法，比较2012年6月至2013年12月住院的32例结核性脑膜炎患儿(TBM组)和30例非结核性颅内感染患儿(非TBM组)的IGRAs、结核菌素皮肤试验(TST)、结核杆菌抗体(TB-IgG)及脑脊液结核分枝杆菌DNA(TB-DNA)阳性率的差异，以及各指标的灵敏度、特异度、阳性预测值和阴性预测值。结果　IGRAs、TST、TB-IgG、脑脊液TB-DNA，在TBM组的阳性率分别为87.50%、56.25%、46.88%、34.38%，非TBM组为6.67%、23.33%、20%、0%，差异均有统计学意义(P<0.05)。IGRAs、TST、TB-IgG、TB-DNA的灵敏度分别为87.5%、56.25%、46.88%、34.38%，特异度分别为93.33%、76.67%、80.00%、100%，各指标灵敏度和特异度的差异均有统计学意义(P<0.05)；IGRAs的灵敏度高于其他三项指标，差异均具有统计学意义(P<0.017)。IGRAs、TST、TB-IgG、TB-DNA的阳性预测值分别93.33%、72%、71.43%、100%，阴性预测值分别为87.50%、62.16%、58.54%、58.82%。结论　IGRAs、TST、TB-IgG、TB-DNA对结核性脑膜炎都具有诊断价值，IGRAs的灵敏度和特异度相对较高。

Abstract: Objective　To investigate the diagnostic value of interferon gamma release assays (IGRAs) in children
with tuberculous meningitis. Methods The prospective case-control study was applied. From January 2012 to March 2013,
32 children diagnosed with tuberculous meningitis (TBM group) and 30 children diagnosed with non-tuberculous meningitis (non-TBM group) were recruited. The positive rates of the interferon gamma release assays (IGRAs), tuberculin skin test (TST), mycobacterium tuberculosis antibody test (TB-IgG), cerebrospinal fluid of mycobacterium tuberculosis DNA test (TB-DNA), and the sensitivity, specificity, negative and positive predictive value of all these tests were compared between TBM group and non-TBM group. Results The positive rate of IGRAs, TST, TB-IgG, and TB-DNA was 87.50%, 56.25%, 46.88% and 34.38% respectively in TBM group, and 6.67%, 23.33%, 20% and 0% respectively in non-TBM group. The differences were statistically significant (P<0.05). The sensitivity of IGRAs, TST, TB-IgG, and TB-DNA was 87.5%, 56.25%, 6.88% and 34.38% respectively. The specificity of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 76.67%, 80.00% and 100% respectively. The differences of sensitivity and specificity were statistically significant (P<0.05). The sensitivity of IGRAs was higher than that of other tests (P<0.017). The positive predictive value of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 72%, 71.43% and 100% respectively. The negative predictive value was 87.50%, 62.16%, 58.54% and 58.82% respectively. Conclusions IGRAs, TST, TB-IgG, and TB-DNA are valuable in the diagnosis of tuberculous meningitis. IGRAs has a relatively higher sensitivity and specificity.

母发光,何海兰,谭泰昌,李毅. γ-干扰素释放试验对儿童结核性脑膜炎的诊断价值[J]. 临床儿科杂志, 2015, 33(3): 242-.

MU Faguang, HE Hailan, TAN Taichang, LI Yi . The value of interferon gamma release assays in the diagnosis of tuberculous meningitis in children[J]. , 2015, 33(3): 242-.

γ-干扰素释放试验对儿童结核性脑膜炎的诊断价值

The value of interferon gamma release assays in the diagnosis of tuberculous meningitis in children

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