抗γ-干扰素自身抗体与γ-干扰素释放试验结果关联性分析

doi:10.19982/j.issn.1000-6621.20250376

摘要/Abstract

摘要：

目的: 探索抗γ-干扰素(IFN-γ)自身抗体与γ-干扰素释放试验(IGRA-ELISA)产生不确定结果之间是否存在相关性。方法: 收集2020年3月至2025年2月南宁市第四人民医院HIV阴性并发机会性感染,同时已进行抗IFN-γ自身抗体检测及IGRA-ELISA检测患者(82例)的相关资料,按照抗IFN-γ自身抗体结果分为阳性组(29例)和阴性组(53例)。通过统计学分析组间差异性,然后纳入对抗IFN-γ自身抗体可能具有独立预测作用的因素构建Firth惩罚逻辑回归模型,探索抗IFN-γ自身抗体关键预测因子。结果: 阳性组患者在机会性感染病原菌方面以非结核分枝杆菌(37.9%,11/29)、马尔尼菲篮状菌(27.6%,8/29)为主。Firth惩罚逻辑回归显示,IGRA-ELISA结果不确定是抗IFN-γ自身抗体阳性的预测因素(OR=56.317,95%CI:3.062~1.020×10¹¹,P<0.01)。结论: 当机会性感染患者IGRA-ELISA结果呈现不确定时,患者体内可能存在抗IFN-γ自身抗体。

关键词: 干扰素类, 抗体, 免疫, 机会致病菌感染

Abstract:

Objective: To explore whether there is a correlation between anti-interferon-gamma (IFN-γ) auto-antibodies and indeterminate results of the IFN-γ release assay (IGRA-ELISA). Methods: We collected data of 82 non-HIV patients with opportunistic infections who underwent both anti-IFN-γ auto-antibody testing and IGRA-ELISA at the Fourth People’s Hospital of Nanning between March 2020 and February 2025. Based on the anti-IFN-γ auto-antibody results, the patients were divided into a positive group (29 patients) and a negative group (53 patients). First, intergroup differences were statistically analyzed. Subsequently, factors possessing potential independent predictive value for the auto-antibodies were incorporated into a Firth penalized logistic regression model, with the ultimate goal of identifying their key predictors. Results: In the positive group, main opportunistic pathogens were nontuberculous mycobacteria (37.9%, 11/29) and Talaromyces marneffei (27.6%, 8/29). Firth penalized logistic regression demonstrated that the indeterminate IGRA-ELISA result was a significant predictor of anti-IFN-γ auto-antibody positivity (OR=56.317, 95%CI: 3.062-1.020×10¹¹, P<0.01). Conclusion: When patients with opportunistic infections present with an indeterminate IGRA-ELISA result, anti-IFN-γ auto-antibodies may be present in patients.

Key words: Interferons, Antibodies, Immunity, Opportunistic infections

中图分类号:

R392.1
R521

于海威, 李倩, 冯凤泉, 李莎. 抗γ-干扰素自身抗体与γ-干扰素释放试验结果关联性分析[J]. 中国防痨杂志, 2026, 48(2): 282-288. doi: 10.19982/j.issn.1000-6621.20250376

Yu Haiwei, Li Qian, Feng Fengquan, Li Sha. Association analysis between anti-interferon-γ auto-antibodies and interferon-gamma release assay results[J]. Chinese Journal of Antituberculosis, 2026, 48(2): 282-288. doi: 10.19982/j.issn.1000-6621.20250376

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参考文献 19

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T、N、P之间浓度差			结果判定
T―N(pg/ml)	T―N(pg/ml)	P―N(pg/ml)	结果判定
≥20	≥25%N	任何值	阳性
≥20	<25%N	≥25	阴性
≥20	<25%N	<25	不确定
<20	/	≥25	阴性
<20	/	<25	不确定

资料	阳性组(29例)	阴性组(53例)	统计检验值	P值
性别[例(构成比,%)]			χ²=0.031	0.860
男性	17(58.6)	30(56.6)
女性	12(41.4)	23(43.4)
平均年龄(岁,$\overline{x}$±s)	51.10±11.82	50.00±14.40	t=0.352	0.725

感染类型	病原菌	例数	构成比(%)
单一感染	非结核分枝杆菌	11	37.9
	马尔尼菲篮状菌	8	27.6
	隐球菌	6	20.7
	毕氏肠微孢子虫^a	1	3.4
混合感染	马尔尼菲篮状菌+非结核分枝杆菌	3	10.4
合计		29	100.00

临床资料	阳性组(29例)	阴性组(53例)	统计检验值	P值
CRP[例(构成比,%)]			χ²=9.872	0.020
<10mg/L	5(17.2)	28(52.8)
>10mg/L	24(82.8)	25(47.2)
RBC(×10¹²/L,$\overline{x}$±s)	3.83±0.68	4.21±0.99	t=―1.821	0.072
HGB(g/L,$\overline{x}$±s)	96.21±23.40	113.10±27.50	t=―2.797	0.006
WBC[×10⁹/L,M(Q₁,Q₃)]	15.20(10.00,19.25)	8.30(6.20,10.95)	U=314.500	<0.001
PLT[×10⁹/L,M(Q₁,Q₃)]	391.00(299.50,462.00)	262.00(206.00,335.00)	U=329.500	<0.001
ALB(g/L,$\overline{x}$±s)	33.87±6.36	37.27±6.07	t=―2.385	0.019
FERR[μg/L,M(Q₁,Q₃)]	416.30(278.05,739.70)	462.00(268.55,676.60)	U=754.500	0.892
NEU%[%,M(Q₁,Q₃)]	76.40(72.75,81.85)	80.10(71.60,88.60)	U=643.500	0.225
LYM%[%,M(Q₁,Q₃)]	13.40(8.20,16.25)	11.30(6.75,19.10)	U=712.500	0.587
NEU[×10⁹/L,M(Q₁,Q₃)]	11.40(8.25,15.05)	6.80(4.55,9.50)	U=381.000	<0.001
LYM[×10⁹/L,M(Q₁,Q₃)]	1.90(1.20,2.70)	1.01(0.60,1.50)	U=317.500	<0.001
ALP[U/L,M(Q₁,Q₃)]	113.10(74.95,215.60)	77.00(51.15,96.15)	U=411.000	<0.001
PT[s,M(Q₁,Q₃)]	14.50(13.35,15.05)	13.70(13.05,14.25)	U=540.000	0.027
APTT[s,M(Q₁,Q₃)]	38.45(32.70,43.50)	32.80(29.45,38.85)	U=522.000	0.017
INR[M(Q₁,Q₃)]	1.12(1.01,1.19)	1.00(1.00,1.10)	U=520.000	0.015
ESR(mm/1h,$\overline{x}$±s)	90.85±40.68	50.63±30.33	t=5.075	<0.001
CD3⁺(×10⁹/L,$\overline{x}$±s)	1332.05±672.22	741.84±435.10	t=4.819	<0.001
CD4⁺[×10⁹/L,M(Q₁,Q₃)]	664.64(423.32,904.50)	396.00(255.00,553.00)	U=382.000	<0.001
CD8⁺(×10⁹/L,$\overline{x}$±s)	587.49±360.10	277.47±174.53	t=4.364	<0.001
CD4/CD8[M(Q₁,Q₃)]	1.17(1.00,1.66)	1.56(1.04,2.14)	U=633.000	0.189

临床资料	抗IFN-γ自身抗体		统计检验值	P值
临床资料	阳性组(29例)	阴性组(53例)	统计检验值	P值
三分类IGRA结果[例(构成比,%)]			χ²=48.381	<0.001
阳性	2(6.9)	14(26.4)
阴性	7(24.1)	39(73.6)
不确定	20(69.0)	0(0.0)	δ=7.0	<0.001
二分类IGRA结果[例(构成比,%)]			χ²=48.343	<0.001
有结果	9(31.0)	53(100.0)
不确定	20(69.0)	0(0.0)