基因芯片技术检测方法对耐多药肺结核治疗的指导价值研究

Clinical study on detection of drug resistance genes in the treatment of patients with pulmonary tuberculosis

目的探讨基因芯片技术在肺结核耐药检测中的应用及指导临床治疗的价值。方法河北省胸科医院结核科住院的83位复治菌阳肺结核患者为选例对象,根据既往药敏试验结果,择符合条件的56例耐多药肺结核患者作为研究对象,随机分为基因芯片组24例根据基因芯片检测结果制定抗结核化疗方案,常规药敏组32例根据常规药敏试验结果制定抗结核化疗方案,观察评价两组在治疗后痰菌阴转情况及肺部病灶吸收情况。结果痰菌阴转情况基因芯片组58.3%(14/24),常规药敏组53.2%(17/32),基因芯片组略高于常规药敏组,组间相比无显著性差异(P>0.05);X线肺部病灶吸收情况基因芯片组45.9%(11/24),常规药敏组43.8%(14/32),组间相比无显著性差异(P>0.05)。结论基因芯片技术快速准确,可用于肺结核的耐药检测,指导临床用药。

Objective To investigate the application of gene chip in the detection of antimicrobial resistance in patients with pulmonary tuberculosis. Methods There were 83 patients with relapse bacillary pulmonary tubercu- losis. On the basis of antibiotic sensitivity test results, 56 multi-drug resistant pulmonary tuberculosis patients were randomly divided into two groups. The gene chip group （ n = 24 ） was given individualized anti-tuberculosis chemo- therapy based on gene chip detection results, and the observation group was given anti-tuberculosis chemotherapy based on conventional drug susceptibility. The rate of lesions absorbed and sputum bacteria negative-transformation was observed. Results The sputum bacteria negative transformation rate was 58.3% in the gene chip group, which was slightly higher than 53.2% in the observation group. 45.9% had lesions absorbed in the gene chip group, which was slightly higher than 43.8% in the observation group. Conclusion Gene chip technology is fast and accurate, which can be used for tuberculosis drug resistance detection.