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目的探讨γ干扰素释放试验在广州地区艾滋病合并疑似结核感染人群中的诊断价值。方法以2015年7月至2016年1月于广州市第八人民医院就诊的252例艾滋病患者为研究对象,根据临床表现、辅助检查等将其分成三组:确诊结核组(n=24)、可疑结核组(n=70)、非结核组(n=158);应用TSPOT.TB试剂盒检测各组患者外周血γ干扰素水平;利用SPSS 13.0统计软件分析检测结果。结果γ干扰素释放试验试剂TSPOT.TB诊断艾滋病合并结核的敏感性为56.38%,特异性为92.40%;在诊断HIV合并肺结核时,TSPOT.TB诊断的敏感性显著低于诊断HIV合并肺外结核(45.54%vs.71.80%,P=0.011),而特异性显著高于诊断HIV合并肺外结核(98.78%vs.84.21%,P=0.003);活动性结核组CD4~+T细胞计数≥200/μL及<200/μL的患者中TSPOT.TB检测阳性率分别为60.0%和58.0%,但差异无统计学意义。绘制TSPOT.TB试验对艾滋病合并疑似结核的诊断价值ROC曲线,曲体下面积为0.744(95%CI:0.676~0.812)。结论 TSPOT.TB试验在广州地区艾滋病合并疑似结核感染人群中有一定的辅助诊断价值。
Objective To investigate the diagnostic value of interferon gamma release in people with suspected TB infection in Guangzhou. Methods A total of 252 HIV / AIDS patients treated in Guangzhou Eighth People’s Hospital from July 2015 to January 2016 were divided into three groups according to their clinical manifestations and laboratory tests: tuberculosis (n = 24) Susceptible TB group (n = 70) and non-TB group (n = 158). TSPOT.TB kit was used to detect peripheral blood IFN-γ levels in each group. SPSS 13.0 software was used to analyze the results. Results The sensitivity and specificity of TSPOT.TB for diagnosing AIDS complicated with tuberculosis were 56.38% and 92.40% respectively. The diagnostic sensitivity of TSPOT.TB in diagnosing HIV-associated tuberculosis was significantly lower than that of diagnosing HIV complicated with extra-pulmonary tuberculosis (45.54% vs.71.80%, P = 0.011), while the specificity was significantly higher than that of diagnosing HIV complicated with extrapulmonary tuberculosis (98.78% vs 84.21%, P = 0.003). The CD4 ~ + T cell count in active TB group was ≥200 The positive rates of TSPOT.TB in patients with / μL and <200 / μL were 60.0% and 58.0%, respectively, but the difference was not statistically significant. To draw the ROC curve of diagnostic value of TSPOT.TB test for AIDS-associated suspected tuberculosis, the area under the curve was 0.744 (95% CI: 0.676-0.812). Conclusion The TSPOT.TB test has some auxiliary diagnostic value in people with suspected tuberculosis infection in Guangzhou area.