结核感染药物治疗中耐药突变基因检测结果分析

Results Analysis of Mutant Gene Detection of Tuberculosis Infection in Drug Therapy

目的探讨结核感染药物治疗中结核分枝杆菌(MTB)耐药突变基因检测对利福平(RFP)、异烟肼(INH)、链霉素(SM)和乙胺丁醇(EB)的检查结果在临床用药方面的应用价值。方法应用耐药突变基因实验方法和痰快速培养药敏(BACTEC MGIT 960培养系统)分别检测肺结核感染患者各60例,对耐药结果进行对比。结果用耐药突变基因实验和痰快速培养药敏检测:利福平、异烟肼、链霉素和乙胺丁醇的药敏结果的耐药百分率分别为35.00%、21.67%,56.67%、45.00%,36.67%、31.67%,16.67%、10.00%。χ2分别为2.627,0.989,0.333,1.154,P值均>0.05,说明两种方法的差异统计学意义。统计耐药肺结核疾病患者应用耐药突变基因检测药敏结果,四种药物相应最常见突变位点分别为S531L、-15M、43M、306M2,占该药突变位点检出总数的59.09%、70.93%、60.00%、73.91%。结论耐药突变基因实验在结核感染临床用药治疗方面,优于其他方法具有很高的应用价值。

Objective To investigate the Mycobacterium tuberculosis infection in drug therapy mutant gene detection of rifampicin,isoniazid,streptomycin and ethambutol test results and application value in the clinical treatment. Methods Application of gene mutant experimental method and sputum rapid culture and drug sensitivity（ BACTEC MGIT 960 culture system） were detected in 60 patients with pulmonary tuberculosis,to compare the resistance results. Results A genetic experiment and sputum culture and drug sensitive test for rapid resistance mutation results： percentage of rifampicin,isoniazid resistant drug sensitivity test,streptomycin and ethambutol were 35. 00% 、21. 67%; 56. 67% 、45. 00%; 36. 67% 、31. 67%; 10. 00% 、16. 67%. χ2= 2. 627,0. 989,0. 333,1. 154,P 0. 05,the difference between the two methods had no statistical significance. A statistical analysis of patients with pulmonary tuberculosis disease resistance gene detection of resistance mutations in drug sensitivity results. The most common mutations were S531 L,-15 M,43M,306M2,which accounted for 59. 09%,70. 93%,60%,73. 91% of the total number of mutations detected in four medicine. Conclusion The drug resistance mutation detection in tuberculosis infection in clinical drug treatment,better than other detection method has high application value.