发热患者中γ干扰素释放实验QuantiFERON-TBGold In Tube不确定结果及影响因素
Factors associated with indeterminate results of QuantiFERON TB Gold In-Tube Test in adult patients with fever

朱琳.发热患者中γ干扰素释放实验QuantiFERON-TBGold In Tube不确定结果及影响因素[J].内科急危重症杂志,2019,25(4):292-294

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DOI：10.11768/nkjwzzzz20190409

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基金项目:国家自然科学基金资助项目(No:81600471)

作者	单位	E-mail
朱琳	华中科技大学同济医学院附属同济医院	qning@vip.sina.com

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中文摘要:

目的：探讨发热患者中γ干扰素释放实验QuantiFERON-TB Gold In-Tube（QFT-GIT）不确定结果及影响因素。方法：选择感染科因发热收治入院的病例，统计患者一般状况、实验室检查包括γ干扰素释放实验QFT-GIT，血常规、血清白蛋白、补体、降钙素原（PCT）、超敏C反应蛋白（hs-CRP）、乳酸脱氢酶（LDH）、血清铁蛋白（SF）等炎症指标，并进行统计学分析。结果：215例患者中，QFT试验阳性83例，阴性66例，不确定结果66例。QFT-QIT不确定组患者年龄、SF及LDH水平显著高于QFT确定组(P<0.01或P<0.05)，淋巴细胞计数及血清白蛋白、补体C3、C4水平显著低于确定结果组(P<0.01或P<0.05)。多因素回归分析显示发热患者中出现QFT不确定结果的独立危险因素有低蛋白血症(OR=1.156, 95% CI 1.028~1.299）、淋巴细胞减少 (OR= 6.009, 95% CI 2.147~16.817）、高白细胞计数(OR=0.800, 95% CI 0.680~0.941）。结论：发热患者中QFT-GIT不确定结果出现比例较高，尤其是在低蛋白血症、低淋巴细胞血症及炎症反应强烈的患者。

英文摘要:

Objective: To evaluate the associated factors of indeterminate results of QuantiFERON-TB Gold In-Tube Test (QFT-GIT) in adult patients admitted with fever. Methods: We retrospectively enrolled patients admitted with fever in department of infectious diseases to collect general conditions, laboratory examinations including QFT-GIT, blood routine test, albumin level, serum complement, inflammatory indicators such as PCT, hs-CRP, LDH, SF, and final diagnosis. Results: 215 hospitalized patients with fever were retrospectively enrolled into this study, among which there were 83 positive cases, 66 negative cases and 66 indeterminate cases. The age, the levels of SF and LDH in patients with indeterminate results were significantly higher than those in patients with determinate results (P<0.01 or P<0.05). Meanwhile, lymphocyte counts, serum albumin level, serum complements C3 and C4 levels in patients with indeterminate results were significantly lower than those in patients with determinate results (P<0.01 or P<0.05). Multivariate logistic regression analysis revealed that hypoproteinemia (OR: 1.156; 95% CI: 1.028-1.299), lymphocytopenia (OR: 6.009; 95% CI: 2.147-16.817), and increased white blood cell counts (OR: 0.800; 95% CI: 0.680-0.941) were significant predictors of QFT indeterminate results. Conclusion: Indeterminate results of QFT-GIT were not infrequent in patients with fever, especially in patients with hypoproteinemia, lymphocytopenia and strong inflammatory response.