中国防痨杂志2025，Vol.47Issue(11)：1481-1488,8.DOI:10.19982/j.issn.1000-6621.20250286
慢性非免疫系统性疾病对γ-干扰素释放试验检测结核感染敏感性的影响
Effect of chronic non-immune system diseases on the sensitivity of interferon-γ release assay for the detection of tuberculosis infection
摘要
Abstract
Objective:To investigate the effect of chronic non-immune system diseases on the sensitivity of interferon-gamma release assay(IGRA)for detection of tuberculosis(TB)infection.Methods:A retrospective study was conducted.Electronic medical records of inpatients at the Second Hospital of Hebei Medical University from January to October 2024 were collected.A total of 3057 inpatients with complete clinical data were selected,following an approximate 1∶1 ratio of IGRA-positive to IGRA-negative cases.The data included clinical diagnosis of TB or chronic non-immunological diseases,IGRA results,and spot-forming cell counts,as well as age and gender data closely related to the above diseases.After excluding 125 patients with active TB and 98 with a history of TB,2834 patients were included to analyze the effect of chronic non-immune diseases on the sensitivity of IGRA for detection of TB infection.Results:Among the 2834 patients without definitive evidence of TB infection,1534(54.13％)were male and 1300(45.87％)were female,with an age range of 4 months to 98 years(median(IQR):57.0(37.0,68.0)years).There were 1300(45.87％)IGRA-positive and 1534(54.13％)IGRA-negative cases.Patients with comorbidities included anemia(531,18.74％),hypoalbuminemia(591,20.85％),diabetes(541,19.09％),hypertension(965,34.05％),hepatitis B(96,3.39％),and tumors(709,25.02％).Among tumor cases,393(55.43％)were malignant tumors,78(11.00％)were suspected malignancies,and 238 were(33.57％)benign tumors.Multivariate logistic regression analysis showed that,compared to females,non-diabetics,and the 0-9 years age group,the risk of a positive IGRA was significantly increased in males,patients with diabetes,and those in the 10-19,20-49,and 50-98 years age groups(OR(95％CI):1.773(1.507-2.085),1.453(1.183-1.785),3.405(1.143-10.142),22.070(8.027-60.678),and 45.822(16.732-125.486),respectively).Conversely,patients with anemia had a decreased likelihood of a positive IGRA compared to non-anemic patients(OR(95％CI)=0.591(0.477-0.732)).Conclusion:Anemia may lead to the false-negative results of the IGRA test,whereas diabetes mellitus may lead to the false positivity or increased TB infection.These findings suggest that IGRA results should be interpreted cautiously in patients with these comorbidities to avoid misdiagnosis.关键词
分枝杆菌感染/干扰素γ/免疫学试验/慢性病/共病现象Key words
Tuberculosis infection/Interferon-gamma/Immunologic tests/Chronic disease/Comorbidities分类
临床医学引用本文复制引用
刘增宾,李桂莲,魏会强,刘佳佳,武娅宁,王亚飞,许达,黄咪孙,张敬蕊,李马超,李晓毅..慢性非免疫系统性疾病对γ-干扰素释放试验检测结核感染敏感性的影响[J].中国防痨杂志,2025,47(11):1481-1488,8.基金项目
河北省2025年度医学科学研究课题计划项目(20250522) Hebei Province 2025 Medical Scientific Research Project Plan(20250522) （20250522）
