γ-干扰素释放试验在肺结核病患者和高危人群中的应用及诊断价值

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1、授予单位代码10089学号或申请号13781Y妗(E搿大5HebeiMedicalUniversity硕士学位论文在职科学学位�干扰素释放试验在肺结核病患者和高危人群中的应用及诊断价值学位申请人：宋韬导师：高官聚教授专业：内科学二级学院：河北省胸科医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科

2、材料、原始数据、申报的专利等知识产权均归河北医科承担相应法律责仏研究生签名:导师签章二鉍2d，年�T月）r曰河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名:农輪导师签章：参菸衮PC年�r月•/日目录中文摘要··········································································

3、·······1英文摘要·················································································3英文缩写·················································································5研究论文γ-干扰素释放试验在肺结核病和高危人群中的应用及诊断价值前言························································

4、························6材料与方法·······································································7结果···············································································12附图···············································································13附表

5、···············································································15讨论···············································································16结论···············································································18参考文献···················

6、······················································19综述γ-干扰素释放试验的基础理论及其在国内外的研究进展············22致谢·····················································································31个人简历···············································································3

7、2中文摘要γ-干扰素释放试验在肺结核病患者和高危人群中的应用及诊断价值摘要结核病是由结核分枝杆菌引起的慢性传染性疾病。据报道全世界20亿人感染MTB，其中800万为活动性肺结核，其余均为潜伏结核感染。近年来结核病疫情呈现上升趋势，早期快速诊断肺结核病及LTBI是结核病防控的关键。长期以来我国对结核病的诊断方法有很多不足：MTB培养阳性是诊断结核病的金标准，但耗时长且敏感性低；痰抗酸染色取样困难、阳性率低、无法区分非结核分枝杆菌感染；结核菌素皮素试验应用广泛但其特异性差。γ-干扰素释放试验通过检测机体内MTB基因组差异区1编码的抗原早期

8、分泌靶向抗原6000蛋白和培养滤过蛋白-10肽段刺激后分泌γ-干扰素的特异性T细胞数量来诊断结核感染，它不受机体免疫状态及卡介苗接种的影响，具有很好的敏感性和特异性。但目前国内外对于IGRAs在临床的应用价值争议较大。因