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对于QuantiFERON-TB Gold Plus^®的回归预测模型在免疫抑制患者中产生不确定的结果

Rahma Bellagha¹, Tarak Dhaouadi¹, Awatef Riahi¹

¹Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia.

SAGE open medicine

|September 12, 2024

概括

来自QuantiFERON-TB Gold Plus测试的不确定结果可能会延迟治疗. 免疫抑制疗法,淋巴缺血症,低蛋白血症和脏问题是这些结果的关键风险因素.

科学领域:

免疫学免疫学免疫学
传染性疾病传染性疾病
临床医学临床医学

背景情况:

在开始抗瘤亡因子 (TNF) 治疗之前,查潜在结核病感染 (LTBI) 是至关重要的.
干扰素-释放测试 (IGRA) 是LTBI查的标准.
不确定的IGRA结果对及时启动治疗构成挑战.

研究的目的:

在突尼斯患者中确定不确定的QuantiFERON-TB Gold Plus (QFT-Plus) 结果的频率.
确定与未确定QFT-Plus结果相关的临床和生物风险因素.

主要方法:

一项涉及712名患者的横截面研究,这些患者正在接受自身免疫性疾病监测,并被考虑用于抗TNF治疗.
QFT-Plus测试是在全血样本上进行的.
分析的潜在风险因素包括人口统计,并发症,药物使用和实验室参数 (淋巴细胞计数,白蛋白,eGFR).

主要成果:

在4.8%的患者中,QFT-Plus测试产生了不确定的结果.
不确定的结果与使用免疫抑制药物 (OR=24.5) 和更长的治疗持续时间 (OR=1.004) 有关.
淋巴缺血症 (p=5E-6),低albuminemia (p=4.3E-4),和降低估计的淋巴细胞过率 (eGFR) (p=0.002) 是显著的生物学风险因素.

结论:

免疫抑制疗法,淋巴缺血症,低蛋白血症和功能障碍被确定为不确定QFT-Plus结果的显著风险因素.
使用这些生物参数开发的预测得分显示高灵敏度 (91.2%) 和特异性 (99.9%) 对于不确定的结果.
这些发现可以帮助预测和管理在临床实践中不确定的IGRA结果.

关键词:

伊格拉 (IGRA) 是一个量子FERON-TB 黄金免疫抑制免疫抑制不确定结果的不确定的结果.潜伏的结核病感染.

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