外周血中性粒细胞对γ干扰素释放试验结果的影响

doi:10.3969/j.issn.1673-8640.2023.05.014

摘要/Abstract

摘要：

目的探讨外周血中性粒细胞对γ干扰素释放试验（IGRA）阳性程度的影响。方法采集2020年10月—2022年3月上海市松江区中心医院234例临床诊断疑似肺结核患者全血样本，根据年龄将234例患者分为青少年组（<40岁）、中年组（40~<60岁）和老年组（>60岁）。检测所有患者血常规，提取外周血单个核细胞进行IGRA。收集所有患者常规检查结果和相关临床资料。将测试孔斑点数-空白对照孔斑点数11~14个（临近Cut-off值）定义IGRA弱阳性，>14个定义为IGRA阳性，<11个定义为IGRA阴性。分析不同年龄、性别患者中性粒细胞计数与IGRA阳性程度的关系。纳入2例临床病例进行验证。结果 IGRA弱阳性患者中性粒细胞计数[（6.15±3.22）×10⁹/L]显著高于阳性患者[（5.05±2.66）×10⁹/L]（P=0.030 2）；青少年组中，IGRA弱阳性患者中性粒细胞计数[（7.54±4.46）×10⁹/L]显著高于阳性患者[（4.00±1.49）×10⁹/L]（P=0.000 2）；男性患者中，IGRA弱阳性患者中性粒细胞计数[（6.49±3.49）×10⁹/L]高于阳性患者[（5.28±2.54）×10⁹/L]（P=0.040 8）。临床病例验证结果显示，中性粒细胞计数低的患者更易出现IGRA阳性结果。结论中性粒细胞计数会影响IGRA阳性程度，建议在采用IGRA辅助诊断结核病时应排除中性粒细胞对IGRA结果的影响。

关键词: 中性粒细胞, γ干扰素释放试验, 肺结核

Abstract:

Objective To investigate the effect of peripheral neutrophils on the positive degree of interferon-gamma release assay（IGRA）. Methods From October 2020 to March 2022，the whole blood of suspected tuberculosis patients were collected，according to ages they are classified into teenage（<40 years old），middle age（40-<60 years old） and elderly（≥60 years old） groups. Routine blood examination was performed. Peripheral blood mononuclear cells from tuberculosis patients were isolated for IGRA. The related data and determination results were collected. The results with spot number of test holes-blank control holes 11-14（close to cut-off value） were defined as weak positive，the results with more than 14 were defined as positive，and the results with less than 11 spots were defined as negative. The correlation between neutrophil count and positive degree of IGRA in patients of different ages and sex was analyzed. Two clinical cases were enrolled for verification. Results Among the 234 patients，neutrophil count in weakly positive group [（6.15±3.22）×10⁹/L] was higher than that in positive group [（5.05±2.66）×10⁹/L，P=0.030 2]. The neutrophil number in teenage weakly positive group [（7.54±4.46）×10⁹/L] was higher than that in positive group [（4.00±1.49）×10⁹/L，P=0.000 2]. The number of neutrophils in male patients with weakly positive group [（6.49±3.49）×10⁹/L] was higher than that in positive group [（5.28±2.54）×10⁹/L，P=0.040 8]. Clinical case verification results showed that patients with low neutrophil count were more likely to have positive IGRA results. Conclusions Neutrophil count affects the positive degree of IGRA，so the effect of neutrophils should be excluded in the auxiliary diagnosis of tuberculosis.

Key words: Neutrophil, Interferon-gamma release assay, Tuberculosis

中图分类号:

R446.11

杨丽媛, 戴碗琴, 汪小桐, 娄晓丽, 王玥, 侯彦强. 外周血中性粒细胞对γ干扰素释放试验结果的影响[J]. 检验医学, 2023, 38(5): 484-488.

YANG Liyuan, DAI Wanqin, WANG Xiaotong, LOU Xiaoli, WANG Yue, HOU Yanqiang. Effect of peripheral blood neutrophils on interferon-gamma release assay of Mycobacterium tuberculosis[J]. Laboratory Medicine, 2023, 38(5): 484-488.

图/表 8

参考文献 16

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组别	例数	IGRA弱阳性/（×10⁹/L）	IGRA阳性/（×10⁹/L）	t值	P值
青少年组	52	7.54±4.46	4.00±1.49	3.95	0.000 2
中年组	46	5.90±3.13	4.78±2.30	1.25	0.218 7
老年组	136	5.92±3.01	5.56±2.99	0.51	0.613 1

组别	例数	IGRA弱阳性/（×10⁹/L）	IGRA阳性/（×10⁹/L）	t值	P值
青少年组	52	7.54±4.46	4.00±1.49	3.95	0.000 2
中年组	46	5.90±3.13	4.78±2.30	1.25	0.218 7
老年组	136	5.92±3.01	5.56±2.99	0.51	0.613 1

性别	例数	IGRA弱阳性/（×10⁹/L）	IGRA阳性/（×10⁹/L）	t值	P值
男性	158	6.49±3.49	5.28±2.54	2.06	0.040 8
女性	76	5.17±2.08	4.58±2.85	0.59	0.553 8

性别	例数	IGRA弱阳性/（×10⁹/L）	IGRA阳性/（×10⁹/L）	t值	P值
男性	158	6.49±3.49	5.28±2.54	2.06	0.040 8
女性	76	5.17±2.08	4.58±2.85	0.59	0.553 8

日期	IGRA				中性粒细胞计数/（×10⁹/L）
日期	阴性质控孔/个	抗原检测孔/个	阳性质控孔/个	结果	中性粒细胞计数/（×10⁹/L）
2021-09-22	0	>50	>100	阳性	5.96
2021-10-11	0	12	>100	弱阳性
2021-10-12					10.86