Pediatrics:IP-10与QFR-IT实验诊断结核病的灵敏度

2014-12-03 MedSci MedSci原创译

干扰素γ和IP-10释放实验都可以诊断结核病(tuberculosis,TB)。为了比较IP-10和QFT-IT(QuantIFERON-TB Gold In-tube)诊断TB的准确性,哥本哈根大学医学院的Line Lindebo Holm医生对坦桑尼亚地区TB感染的住院儿童展开调查,研究结果发表在近期的Pediatrics上。研究者对有TB症状的住院患儿分别使用QFT-IF和IP-10实验进行

干扰素γ和IP-10释放实验都可以诊断结核病(tuberculosis,TB)。

为了比较IP-10和QFT-IT(QuantIFERON-TB Gold In-tube)诊断TB的准确性,哥本哈根大学医学院的Line Lindebo Holm医生对坦桑尼亚地区TB感染的住院儿童展开调查,研究结果发表在近期的Pediatrics上。

研究者对有TB症状的住院患儿分别使用QFT-IF和IP-10实验进行检测,以确诊TB的成人作对照。
研究共纳入了平均年龄为3岁的203名儿童,这些儿童中有38%为HIV感染,36%的患儿年龄小于2岁,58%的患儿体重低于平均水平。

IP-10和QFT-IT实验的结果具有可比性,但是灵敏度低:对于确诊TB患儿检出率为33%,对于可能TB患儿检出率为29%。

两种检验方法的反应率很高:IP-10反应率为29%,QFT-IT反应率为26%。年龄小于2岁与检验方法的反应率具有相关性,IP-10的调整OR值为2.2,P=0.02,QFT-IT的调整OR值为2.4,P=0.01。TB暴露与阳性IP-10检验结果有相关性,调整OR值为3.6,P=0.01,但是与阳性QFT-IT检验结果没有明显相关性,调整OR值为1.4,P=0.52。对于102名成人,两种检验方法的灵敏度都是80%。

研究表明,尽管IP-10和QFT-IT检测坦桑尼亚成人TB的灵敏度高,但是检测儿童TB的灵敏度很低。两种检测方法都不能检测出幼儿的TB感染情况。所以不建议在TB流行地区用这两种方法检测住院儿童的TB感染情况。

原始出处:

Holm, L.L., et al., A Comparison of Interferon-gamma and IP-10 for the Diagnosis of Tuberculosis. Pediatrics, 2014. 134(6): p. e1568-75.

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    2015-02-09 respect
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    2015-01-10 hbwxf
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    2015-05-22 feather89
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