应用RNA恒温扩增实时荧光检测技术观察抗结核药物的疗效

Application of Isothermal RNA Amplification Real-time Fluorescence Detection Technology to Observe the Curative Effect of Anti-TB drugs

目的探讨应用RNA恒温扩增实时荧光检测技术检测痰液中结核分枝杆菌作为肺结核患者化疗效果监测指标的可行性和临床价值。方法 150例接受正规抗结核药物组合治疗的初治涂阳培阳肺结核患者,按照规定时间间隔同时做集菌涂片法、罗氏培养法、TB-PCR和SAT检测,总结各方法的动态变化规律,考察实时荧光核酸恒温扩增检测技术(SAT)在抗结核治疗药物效果检测方面的应用价值。结果抗结核药物治疗1月时TB-PCR法阳性率高于罗氏培养法,χ2=3.8662,P=0.0493,P<0.05;而SAT法与罗氏培养法相比,χ2=0.1730,P=0.6775,P>0.05,无统计学意义;其它时间段3种方法阳性率均无统计学意义。结论实时荧光核酸恒温扩增检测技术(SAT)在抗结核治疗药物效果检测方面的应用,虽不能直接作出药物敏感试验,但可以最快地直接判断所用药物的疗效,及时调整药物使用,可大大降低医疗成本和耐药产生的机会,大幅度减少医疗时间和费用。

OBJECTIVE To study the feasibility and clinical value of the isothermal RNA amplification assay for detection of Mycobacterium tuberculosis in sputum samples as chemotherapy index of pulmonary tuberculosis patients. METHODS 150 initial treatment pulmonary tuberculosis patients with smear and culture positive accepting formal anti tuberculosis drug therapy combination,In accordance with the provisions of the time interval smear and Lowen Stein-Jensen（ L-J） culture and SAT and TB-PCR were used to detect Mycobacterium tuberculosis at the same time,so that sum up dynamic change rule of various methods and inspect clinical value of SAT for detection of Mycobacterium tuberculosis in sputum samples as chemotherapy index of pulmonary tuberculosis patients. results The positive rate of TB-PCR method were significant higher than that of L-J culture method after anti-TB drugs treatment for1 month,χ^2= 3. 8662,P = 0. 0493,P〈0. 05; while the SAT method compared with L-J culture method,χ^2=0. 1730,P = 0. 6775,P〉0. 05,no statistical significance; Other time period the positive rate of three methods had no statistical significance. CONCLUSION The application of SAT technology in anti-TB treatment effects monitoring,though not directly make the drug sensitive test,but it can be the fastest to judge the curative effect of medicine used directly,timely adjustment of drug use,can significantly reduce medical costs and drug resistance,greatly reduce the medical cost and time.