目的 探究γ-干扰素释放试验(IGRA)在儿童肺结核(PTB)中的诊断价值，分析IGRA假阴性结果的影响因素。方法 纳入2018年1月至2023年6月住院治疗的77例确诊PTB患儿为研究对象，根据IGRA结果分为阳性组和阴性组，探究IGRA诊断儿童PTB的敏感度，并分析其假阴性结果的影响因素。结果 结核菌素皮肤试验(TST)诊断儿童PTB灵敏度为67.53%(52/77)，IGRA灵敏度为77.92%(60/77)，二者一致率为79.22%，Kappa值为0.48，具有中等一致性。TST硬结反应（中度阳性OR=0.07，95%CI：0.009~0.471，P=0.007，强阳性OR=0.02，95%CI：0.002~0.275，P=0.003）和白蛋白-球蛋白比值(OR=17.19，95%CI：2.38~124.25，P=0.005)是IGRA假阴性结果的独立影响因素。结论 儿童免疫系统发育不成熟，IGRA阴性反应需警惕假阴性结果的可能，应重视分子生物学和病理学检查，尽早明确诊断，以免延误病情，错过最佳治疗时机。

Objective To investigate the diagnostic value of interferon-gamma release assay (IGRA) in pediatric pulmonary tuberculosis (PTB) and analyze the risk factors of negative IGRA results. Method A total of 77 children with confirmed PTB who were hospitalized in our hospital from January 2018 to June 2023 were included in the study. Based on IGRA results, they were categorized into positive and false-negative groups. The sensitivity of IGRA for diagnosing pediatric PTB was evaluated, and the factors contributing to false-negative results were analyzed. Result The sensitivity of Tuberculin skin test (TST) for diagnosing pediatric PTB was 67.53% (52/77), while that of IGRA was 77.92% (60/77). The agreement rate between TST and IGRA was 79.22%, with a Kappa value of 0.48, indicating moderate consistency. Multivariate analysis revealed that the induration reaction of TST (moderate positive OR=0.066, 95%CI:0.009-0.471, P=0.007, strong positive OR=0.023, 95%CI: 0.002-0.275, P=0.003) and albumin-to-globulin ratio (OR=17.193,95%CI: 2.379-124.247, P=0.005) were independent predictors of false-negative IGRA results. Conclusion Due to the immature development of the immune system, children should be vigilant against the possibility of false negative results of IGRA. Emphasis on molecular biological and pathological examinations is crucial for achieving an early and accurate diagnosis, thereby preventing delayed treatment and missed opportunities for optimal care.