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对于接受抗肿瘤坏死因子α治疗的强直性脊柱炎患者,若怀疑存在潜伏性结核感染,γ-干扰素释放试验的随访检测很有用。

Follow-up testing of interferon-gamma release assays are useful in ankylosing spondylitis patients receiving anti-tumor necrosis factor alpha for latent tuberculosis infection.

作者信息

Son Chang-Nam, Jun Jae-Bum, Kim Jong-Heon, Sung Il-Hoon, Yoo Dae-Hyun, Kim Tae-Hwan

机构信息

Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.

出版信息

J Korean Med Sci. 2014 Aug;29(8):1090-3. doi: 10.3346/jkms.2014.29.8.1090. Epub 2014 Jul 30.

Abstract

We evaluated the utility of follow-up interferon-gamma release assays (IGRAs) for the diagnosis of reactivation of latent tuberculosis infection (LTBI) or new tuberculosis in ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor alpha (anti-TNFα). The study participants (n=127) had a negative IGRA screening before receiving anti-TNFα and were evaluated by follow-up IGRA. We retrospectively examined data of the subjects according to age, gender, tuberculosis prophylaxis, concomitant medications, IGRA conversion and anti-TNFα, including type and treatment duration. The median duration of anti-TNFα was 21.5 months, and the median age was 35.3 yr. Of the 127 patients, IGRA conversion was found in 10 patients (7.9%). There was no significant variation between IGRA conversion rate and any risk factors except for age. IGRA conversion rate was not significantly different between AS and rheumatoid arthritis (P=0.12). IGRA conversion was observed in AS patients receiving anti-TNFα in Korea. A follow-up IGRA test can be helpful for identifying LTBI or new tuberculosis in AS patients receiving anti-TNFα.

摘要

我们评估了随访干扰素-γ释放试验(IGRAs)在诊断接受抗肿瘤坏死因子α(抗TNFα)治疗的强直性脊柱炎(AS)患者中潜伏性结核感染(LTBI)再激活或新发结核病的效用。研究参与者(n = 127)在接受抗TNFα治疗前IGRA筛查为阴性,并通过随访IGRA进行评估。我们根据年龄、性别、结核病预防、合并用药、IGRA转换情况和抗TNFα(包括类型和治疗持续时间)对受试者的数据进行了回顾性检查。抗TNFα的中位治疗持续时间为21.5个月,中位年龄为35.3岁。在127例患者中,10例(7.9%)出现IGRA转换。除年龄外,IGRA转换率与任何危险因素之间均无显著差异。AS患者与类风湿关节炎患者的IGRA转换率无显著差异(P = 0.12)。在韩国接受抗TNFα治疗的AS患者中观察到了IGRA转换。随访IGRA检测有助于识别接受抗TNFα治疗的AS患者中的LTBI或新发结核病。

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