| Objective:To investigate the results of gamma-interferon release assay in patients with rheumatic diseases and its influencing factors,so as to better guide the clinical practice of drug use in patients with rheumatic diseases.Methods:This study retrospectively collected the clinical medical records of all patients who underwent interferon gamma release test in Hospital from December 28,2015 to October 1,2020,including gender,age,typical symptoms of tuberculosis infection(such as cough,low fever,night sweats,weight loss,etc.),previous history of tuberculosis infection,tuberculosis exposure history,and whether they had tuberculosis,laboratory tests(including ESR,CRP,lymphocyte,monocyte,neutrophils,platelet,interferon gamma release level),and chest imaging examinations.Patients with rheumatoid diseases diagnosed by rheumatoid immunologists(mainly including rheumatoid arthritis,ankylost spondylitis etc.)who had not been treated with biological agents were selected as the rheumatic disease group,and the other non-rheumatic diseases group.Combined with the clinical data and test results,the clinical characteristics of patients diagnosed with rheumatic diseases and positive IGRA results were analyzed,and the independent risk factors of IGRA results were discussed by Bary Logistic regression analysis.All data were analyzed on SPSS.25 software.Results:1.A total of 1037 patients underwent IGRA examination in the hospital during this period,including 243 patients with rheumatic diseases.Among them,60 patients were positive for interferon release test,182 were negative,and 1 patient with uncertain results,with a positive rate of IGRA of 24.7%.Among 23 patients with rheumatoid arthritis,8 were positive,and the positive rate of IGRA was 34.8%.Thirteen of 55 patients with ankylosing spondylitis were positive,and the positive rate of IGRA was 23.6%.Of 118 patients with psoriasis,28 had a positive rate of 23.7%.The positive rate of rheumatic diseases group was statistically significant different from that of the total population,and the positive rate of rheumatoid arthritis patients was the highest.2.There was no significant difference in the basic level of IFN-γ between the rheumatic disease group and the non-rheumatic disease group under blank pair care(P=0.68),and there was significant difference in the level of IFN-γ stimulation in the Tubercul-specific antigen stimulation tube(P=0.003<0.05).Patients with elevated ESR also had higher levels of IFN-γ release,and patients with clinical evidence of TB infection had higher levels of IFN-γ release than patients without clinical evidence.There was no significant difference in IFN-γ release between patients with elevated CRP and patients with or without medication history.IFN-γ release levels were not linearly related to lymphocyte count,monocyte count,neutrophil count,and platelet count.3.In patients with rheumatic diseases,age,course of disease and erythrocyte sedimentation rate are the influencing factors of IGRA results.Gender,corticosteroids,immunosuppressant,C-reactive protein,lymphocyte count,monocyte count,neutrophil count,platelet count,the neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and other factors have no statistical significance on IGRA results.Conclusion:Patients with rheumatic diseases due to illness itself B lymphocyte activation abnormal proliferation and T lymphocyte reaction abnormalities,immune response to tuberculosis specific antigen stimulation reaction disorders,IGRA results the positive rate is high,especially in patients with rheumatoid arthritis.Patients with rheumatoid arthritis who are older,have a shorter course of disease,and have elevated erythrocyte sedimentation rate are at higher risk of an IGRA positive result.It is inadequate to use the IGRA screening patients with tuberculosis of the rheumatic diseases,especially for the choice of medication,considering clinical data will be more correct guidance regimen. |
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