γ干扰素释放试验诊断早期结核性盆腔炎的临床价值
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摘要
目的探讨γ干扰素释放试验诊断早期结核性盆腔炎的意义和应用价值。方法选取2014年6月至2017年6月在我院妇科确诊的46例结核性盆腔炎患者作为研究对象(实验组),随机选择同期非结核性盆腔炎患者30例作为对照组(对照组),所有患者采用γ干扰素释放试验联合高通量抗体芯片技术(结核菌特异性IFN-γ ELISPOT检测技术)检测外周血和腹腔镜手术或腹腔穿刺抽取的盆腔积液,比较两组患者结核菌特异性IFN-γ ELISPOT检测技术诊断的特异度、敏感度。结果实验组患者盆腔积液诊断阳性率为97.8%(45/46),外周血诊断阳性率为87.0%(40/46),盆腔积液诊断阳性率明显高于外周血标本(P<0.01)。结核性盆腔炎和非结核性盆腔炎患者采用盆腔积液进行检测,结核性盆腔炎患者的诊断阳性率为97.8%(45/46),非结核性盆腔炎患者的诊断阳性率为10.0%(3/30),不管是采用盆腔积液还是外周血进行检测,结核菌特异性IFN-γ ELISPOT检测技术的诊断敏感度及特异度均>85%。结论结核菌特异度IFN-γ ELISPOT检测技术诊断早期结核性盆腔炎特异性及敏感性高,并且能特异性地区分结核性盆腔炎与非结核性盆腔炎患者,值得临床推广使用。
Objective To explore the significance and application value of interferon-γ release assays(IGRA) in the diagnosis of early pelvic tuberculosis. Methods 46 cases of pelvic tuberculosis patients diagnosed in the Third People's Hospital of Shenzhen from June 2014 to June 2017 were selected as experimental group and randomly 30 cases of non-tuberculous pelvic were selected as control group. The pelvic effusion which was extracted by laparoscopic surgery or abdominal puncture and the peripheral blood of all patients were detected by using tuberculous specific IFN-γ ELISPOT detection techniques(IGRA combining high-throughput antibody chip technology) to evaluate the specificity and sensitivity of the techniques. Results The positive diagnosis rate of pelvic effusion in the experimental group was 97.8%(45/46), 87.0%(40/46) in peripheral blood, and the positive diagnosis rate of pelvic effusion was significantly higher than that of peripheral blood specimens(P<0.01). The positive rate of diagnosis in patients with pelvic tuberculosis was 97.8%(45/46) and 10.0%(3/30) in patients of control group. The diagnostic sensitivity and specificity of tuberculous specific IFN-γ ELISPOT test were more than 85%. Conclusion The tuberculous specific IFN-γ ELISPOT detection technique with highly specific and sensitive to early pelvic tuberculosis can specifically distinguish pelvic tuberculosis from non-tuberculous pelvic inflammation, which is worth clinical promotion.
Objective To explore the significance and application value of interferon-γ release assays(IGRA) in the diagnosis of early pelvic tuberculosis. Methods 46 cases of pelvic tuberculosis patients diagnosed in the Third People's Hospital of Shenzhen from June 2014 to June 2017 were selected as experimental group and randomly 30 cases of non-tuberculous pelvic were selected as control group. The pelvic effusion which was extracted by laparoscopic surgery or abdominal puncture and the peripheral blood of all patients were detected by using tuberculous specific IFN-γ ELISPOT detection techniques(IGRA combining high-throughput antibody chip technology) to evaluate the specificity and sensitivity of the techniques. Results The positive diagnosis rate of pelvic effusion in the experimental group was 97.8%(45/46), 87.0%(40/46) in peripheral blood, and the positive diagnosis rate of pelvic effusion was significantly higher than that of peripheral blood specimens(P<0.01). The positive rate of diagnosis in patients with pelvic tuberculosis was 97.8%(45/46) and 10.0%(3/30) in patients of control group. The diagnostic sensitivity and specificity of tuberculous specific IFN-γ ELISPOT test were more than 85%. Conclusion The tuberculous specific IFN-γ ELISPOT detection technique with highly specific and sensitive to early pelvic tuberculosis can specifically distinguish pelvic tuberculosis from non-tuberculous pelvic inflammation, which is worth clinical promotion.
引文
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[3]Wang HY,Uh Y,Kim S,et al.Performance of the Quantamatrix Multi-plexed Assay Platform system for the differentiation and identification of Mycobacteri-um species[J].J Med Microbiol,2017,66(6):777-787.
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[5]秦建成,徐军,戴亮,等.γ-干扰素释放试验对结核病患者临床诊断性能评价研究[J].传染病信息,2014,27(5):302-305.
[6]Kim JK,Bang WJ,Oh CY,et al.Feasibility of the Interferon-γRelease Assayfor the Diagnosis of Genitourinary Tuberculosis in an Endemic Area[J].Korean J Urol,2013,54(2):123-126.
[7]赵茜,傅潺潺,夏强,等.γ干扰素释放试验在肺内结核和肺外结核中的诊断价值[J].浙江预防医学,2014,26(10):990-997.
[8]刘玉娟,蔡秋娥,段艳辉,等.Elispot检测抗原特异性IFN-γ反应在结核性盆腔炎诊断中的应用价值[J].新发传染病电子杂志,2017,2(3):167-169.
[2]Neonakis IK,Spandidos DA,Petinaki E.Female genital tuberculosis:a review[J].Scand J Infect Dis,2011,43(8):564-572.
[3]Wang HY,Uh Y,Kim S,et al.Performance of the Quantamatrix Multi-plexed Assay Platform system for the differentiation and identification of Mycobacteri-um species[J].J Med Microbiol,2017,66(6):777-787.
[4]World Health Organization.Global Tuberculosis Report2015,20th ed[R].Geneva:World Health Organization;2015
[5]秦建成,徐军,戴亮,等.γ-干扰素释放试验对结核病患者临床诊断性能评价研究[J].传染病信息,2014,27(5):302-305.
[6]Kim JK,Bang WJ,Oh CY,et al.Feasibility of the Interferon-γRelease Assayfor the Diagnosis of Genitourinary Tuberculosis in an Endemic Area[J].Korean J Urol,2013,54(2):123-126.
[7]赵茜,傅潺潺,夏强,等.γ干扰素释放试验在肺内结核和肺外结核中的诊断价值[J].浙江预防医学,2014,26(10):990-997.
[8]刘玉娟,蔡秋娥,段艳辉,等.Elispot检测抗原特异性IFN-γ反应在结核性盆腔炎诊断中的应用价值[J].新发传染病电子杂志,2017,2(3):167-169.
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