背景:结核病(TB)仍然是由于单个转染子而导致死亡的主要原因,结核分枝杆菌(MTB)。潜伏性结核感染(LTBI)是以结核病(TB)的存在为特征的病症,其在临床上并不明显,但仍然显示出对MTB的持续应答。目前,结核菌素皮肤试验(TST)和干扰素γ(IFN-γ)释放试验(IGRAs)主要用于通过T细胞介导的免疫来检测LTBI。对于终末期肾病(ESRD)患者,由于T细胞功能障碍,感染MTB的患者诊断困难。为了获得更准确的LTBI诊断结果,它必须弥补IGRA测试的不足。
方法:本研究纳入了67例血液透析(HD)患者和96例非HD患者,并连续纳入研究人群。通过QuantiFERON-TB金管内(QFT-GIT)测试测量IFN-γ水平。肾功能指标,血尿素氮(BUN),血清肌酐(Cr),和估计的肾小球滤过率(eGFR)用于补偿IGRA测试中IFN-γ水平的下降。
结果:在以前未被发现的个体中,用血清Cr补偿的结果增加了10.81%,允许大约28%的检测,eGFR的补偿增加了5.41%,考虑到其中约14%的可检测潜力,并采用这两种方法可以增强IGRA测试的先前缺点。当两者都被使用时,最大补偿结果显示灵敏度提高8.81%,大约23%以前无法检测到的患者可能被发现。
结论:因此,作为HD患者常规检查以弥补IGRA检测不足的肾功能标志物,可提高LTBI诊断的准确性.
BACKGROUND: Tuberculosis (TB) is still the main cause of mortality due to a single transfectant, Mycobacterium tuberculosis (MTB). Latent tuberculosis infection (LTBI) is a condition characterized by the presence of tuberculosis (TB) that is not clinically apparent but nonetheless shows a sustained response to MTB. Presently, tuberculin skin test (TST) and interferon gamma (IFN-γ) release assays (IGRAs) are mainly used to detect LTBI via cell-mediated immunity of T-cells. For people with end-stage renal disease (ESRD), the diagnosis of patients infected with MTB is difficult because of T-cell dysfunction. To get more accurate diagnosis results of LTBI, it must compensate for the deficiency of IGRA tests.
METHODS: Sixty-seven hemodialysis (HD) patients and 96 non-HD patients were enrolled in this study and the study population is continuously included. IFN-γ levels were measured by the QuantiFERON-TB Gold In-Tube (QFT-GIT) test. Kidney function indicators, blood urea nitrogen (BUN), serum creatinine (Cr), and estimated glomerular filtration rate (eGFR) were used to compensate for the declined IFN-γ levels in the IGRA test.
RESULTS: In individuals who were previously undetected, the results of compensation with serum Cr increased by 10.81%, allowing for about 28% more detection, and compensation with eGFR increased by 5.41%, allowing for approximately 14% more detectable potential among them and employing both of them could enhance the prior shortcomings of IGRA tests. when both are used, the maximum compensation results show a sensitivity increase rate of 8.81%, and approximately 23% of patients who were previously undetectable may be found.
CONCLUSIONS: Therefore, the renal function markers which are routine tests for HD patients to compensate for the deficiency of IGRA tests could increase the accuracy of LTBI diagnosis.