在肺和心脏移植候选者中，将QuantiFERON TB金标试验与结核菌素皮肤试验用于检测潜伏性结核感染的性能比较。
Performance of QuantiFERON TB gold test compared with the tuberculin skin test for detecting latent tuberculosis infection in lung and heart transplant candidates.
作者信息
Mardani Masoud, Farshidpour Maham, Nekoonam Mohsen, Varahram Fatemeh, Najafizadeh Katayoon, Mohammadi Nazila, Sharifkashani Babak, Gachkar Latif, Farokhzad Banafsheh, Droudinia Atousa, Javanmard Pedram, Tabarsi Payam
机构信息
Iranian Infectious Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Exp Clin Transplant. 2014 Apr;12(2):129-32.
OBJECTIVES
Evaluation for latent tuberculosis infection is advised before organ transplant. The interferon-gamma release assay has been shown to be more specific than the tuberculin skin test for screening for latent tuberculosis infection. We compared the tuberculin skin test and QuantiFERON-TB Gold In-Tube test for screening for latent tuberculosis infection and agreement between the tests in heart and lung transplant recipients before transplant.
MATERIALS AND METHODS
Fifty-five adult patients who had been evaluated for heart and lung transplant between September 2011 and September 2012 at Masih Daneshvari Hospital in Iran were prospectively enrolled. We performed the tuberculin skin test and QuantiFERON-TB Gold In-Tube test.
RESULTS
Of the 55 patients, 3 (5%) had positive tuberculin skin test results, and 11 (20%) had positive QuantiFERON-TB Gold In-Tube test results. Agreement between the tuberculin skin test and QuantiFERON-TB Gold In-Tube test was fair (Kappa=0.061; 95% CI: - 0.185-0.307) (P = .56).
CONCLUSIONS
The positivity for QuantiFERON-TB Gold In-Tube test was greater than the positivity for the tuberculin skin test, and QuantiFERON-TB Gold In-Tube test more accurately determined the risk for latent tuberculosis infection. However, a further longitudinal study is necessary to verify that the QFT-G test would predict developing tuberculosis after heart and lung transplant.
目的
建议在器官移植前对潜伏性结核感染进行评估。干扰素-γ释放试验已被证明在筛查潜伏性结核感染方面比结核菌素皮肤试验更具特异性。我们比较了结核菌素皮肤试验和全血γ干扰素释放试验（QuantiFERON-TB Gold In-Tube test）在心脏和肺移植受者移植前筛查潜伏性结核感染的情况以及两种试验结果的一致性。
材料与方法
前瞻性纳入了2011年9月至2012年9月期间在伊朗马西赫·达内什瓦里医院接受心脏和肺移植评估的55例成年患者。我们进行了结核菌素皮肤试验和全血γ干扰素释放试验。
结果
55例患者中，3例（5%）结核菌素皮肤试验结果为阳性，11例（20%）全血γ干扰素释放试验结果为阳性。结核菌素皮肤试验和全血γ干扰素释放试验结果的一致性一般（Kappa=0.061；95%CI：-0.185-0.307）（P = 0.56）。
结论
全血γ干扰素释放试验的阳性率高于结核菌素皮肤试验，且全血γ干扰素释放试验能更准确地确定潜伏性结核感染的风险。然而，需要进一步的纵向研究来验证全血γ干扰素释放试验能否预测心脏和肺移植后结核病的发生。
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