Diagnostic Value Of Interferon-Gamma Release Assay For Liver Disease Patients With Tuberculosis Infection

Background:China is a liver disease and tuberculosis epidemic areas,in liver disease especially hepatic cirrhosis patients,liver injury can lead immunity to reduce,and protein synthesis of obstacles often lead to poor nutrition, so these patients’resistance is very poor.Under the circumstances of TB epidemic,these patients are easily to suffer from TB infection to treat the patients’life;However,the traditional detection methods for TB infection always take a long time and the positive rate is low,often delays the best time for TB infection patients’ diagnosis and treatment;With the development of detection methods,several studies show that interferon-gamma release assay has an important value in the diagnosis of TB.Objective:Through comparing the result of IGRAs in chronic hepatitis and hepatic cirrhosis patients,to discus the value of IGRAs for liver disease with TB infection patients’diagnosis.Methods:1.Collected the data of 127 patients that to be done the IGRAs from April 2014-May 2014 in Chongqing Medical University’s second affiliated hospital,the exclusion criteria is the patient is done the IGRAs but with no liver disease;2.Group (1):78 patients are divided into 37 TB infection patients(6 chronic hepatitis patients,31 hepatic cirrhosis patients) and 41 patients with no TB infection(11 chronic hepatitis patients,30 hepatic cirrhosis patients);(2):Collected the 78 patients’clinical data,however there are 1 chronic hepatitis and 5 hepatic cirrhosis patients are missing the clinical data,so the 72 patients are divided into 56 hepatic cirrhosis and 16 chronic hepatitis patients,and collected the data of ALT、AST、TBIL、WBC、N%;3.According to the formula to calculate sensitivity、specificity、false positive rate、false negative rate、accuracy; SPSS20.0, using Mann-Whitney U test to compare the ALT、AST、TBIL, using t test to compare WBC、 N%, and analyze the correlation for IGRAs results with ALT、AST、TBIL、 WBC、N%；Results:1.In liver disease with TB infection patients, the sensitivity of IGRAs is 72.9%, specificity is 78.1%, false positive rate is 21.9%, false negative rate is 27.1%, accuracy is 75.6%; In hepatic cirrhosis patients, the sensitivity is 74.2%, specificity is 86.7%, false positive rate is 13.3%, false negative rate is 25.8%, accuracy is 80.3%; In chronic hepatitis patients, the sensitivity is 66.7%, specificity is 54.5%, false positive rate is 45.5%, false negative rate is 33.3%, accuracy is 58.5%;2.The group of hepatic cirrhosis patients has 25 IGRAs(+)(44.6%),in chronic hepatitis is 8 IGRAs(+)(50%),the differences has no statistical significance(P=0.480);There are 31 TB(+) in hepatic cirrhosis patients(55.4%) and 6 TB(+) in chronic hepatitis patients(37.5%),the differences has no statistical significance(P=0.814);3.In hepatic cirrhosis patients, the correlation coefficient for the IGRAs result with ALT、AST、TBIL、WBC、N%is 0.063、0.086、0.180、 0.013、0.071,the P is 0.643、0.530、0.184、0.922、0.602; In chronic liver disease patients, he correlation coefficient for the IGRAs result with ALT、 AST、TBIL、WBC、N% is-0.190、-0.244、-0.054、-0.244、-0.054, the Pis:0、481、0.362、0.842、0.362、0、862;4.When the IGRAs (+), chronic hepatitis patients’ALT is higher than hepatic cirrhosis patients, the differences has Statistical significanceoConclusion:When the IGRAs is (+), chronic hepatitis patients’ALT is higher than hepatic cirrhosis patients; And the sensitivity and specificity of IGRAs in liver disease especially hepatic cirrhosis is higher than the chronic liver disease patients, think that IGRAs has an important value in the diagnosis of liver disease patients with TB infection。...