两种基因诊断技术对结核分枝杆菌耐药性检测效果比较

Clinical evaluation of two gene diagnostic techniques for the detection of drug resistance of Mycobacterium tuberculosis

目的:评价探针熔解曲线技术和基因芯片技术在结核病防治工作中对结核分枝杆菌异烟肼和利福平耐药性的检测效果。方法:利用基因芯片技术和探针熔解曲线技术同时对46例涂阳肺结核患者的痰标本进行异烟肼和利福平耐药检测,以传统罗氏药敏试验为金标准,对基因芯片技术和探针熔解曲线技术的检测效果进行评价。结果:在46例菌株中,分别用探针熔解曲线和基因芯片法进行异烟肼耐药基因检测,与罗氏药敏试验的符合率为91.3%和80.43%;对38例进行利福平耐药基因检测,符合率为84%和89.4%。探针熔解曲线技术和基因芯片检测结果比较,差异无统计学意义(P>0.05)。结论:探针熔解曲线和基因芯片检测异烟肼和利福平的耐药性与罗氏药敏试验具有很好的一致性,且两种方法具有简便快速、灵敏度高、特异性好等优点,对临床及时准确进行抗结核治疗具有重要意义。

Objective To evaluate the effect of probe melting curve analysis and gene chips on detecting drug resistance of Mycobacterium tuberculosis against isoniazid and rifampicin. Methods Drug resistance was detected by gene chip and probe melting curve analysis in 46 cases of patients with sputum smear positive specimens, with L-J cuhure as the gold standard. Results In all the 46 cases, the detection of drug resistance genes against isoniazid was performed by probe melting curve analysis and gene chips, achieving the coincidences of 91.3% and 80.43% with those by L-J culture, respectively. The detection of drug resistance genes in 38 cases administered with rifampicin was conducted as well by the two techniques, achieving the coincidences of 84% and 89.4% with those by L-J culture. There were no significant differences between the two methods （P 〉 0.05）. Conclusion The gene chip direct detection and probe mehing curve analysis are of high value in diagnosis of tuberculosis, and they can be regarded as a diagnosis method of choice for tuberculosis. Both have the priorities of timesaving, high sensitivity and specificity.