基因芯片技术对耐药结核分支杆菌的诊断价值

THE VALUE OF GENE CHIP TECHNOLOGY IN THE DIAGNOSIS OF DRUG-RESISTANCE MYCOBACTERIUM TUBERCULOSIS

目的采用基因芯片技术对耐药结核分支杆菌进行检测,为今后制定结核病预防控制策略提供依据。方法选择2012年10月—2014年9月于我院就诊的痰涂片抗酸杆菌检测呈阳性的肺结核病人193例,其中初治病人138例,复治病人55例。应用基因芯片技术对193例病人标本异烟肼、利福平耐药基因进行检测。结果193例肺结核病人总体耐药率为19.17%（37/193）,耐多药率为7.77%（15/193）。复治病人耐药率显著高于初治病人（χ^2=25.460,P〈0.01）;男性病人耐药率显著高于女性病人（χ^2=6.457,P〈0.05）。复治组4个年龄段耐药率比较差异有显著性（χ^2=8.814,P〈0.05）。户籍与非户籍病人耐药率比较差异无显著性（P〉0.05）。结论基因芯片技术可为耐药结核病快速诊断提供依据,复治病人为主要耐药人群。

Objective Applying gene chip technology, to detect drug-resistance in Mycobacterium tuberculosis and pro- vide an evidence for formulating prevention and control strategy of tuberculosis in the future. Methods This study consisted of 193 cases of pulmonary tuberculosis with a positive sputum smear of acid-fast bacillus, who were treated in our hospital during the period from October 2012 to September 2014. Of the patients, 138 received initial treatment, and 55 came for re-treatment. The gene chip technology was used to detect isoniazid-and rifapicin-resistance genes in samples of 193 cases. Results In the 193 cases of pulmonary tuberculosis, total drug-resistance rate was 19.17% （37/193）, of which multi-drug resistance was 7.77% （15/193）. The drug resistance in re-treated patients was higher than that in the first-treated ones （X^2=25.460,P〈20.01）, that in male was higher than female （X^2=6.457,P〈0.05）. In the re-treated group, the differences in drug resistance were significant among four age groups （x^2 = 8.814,P 〈0.05）, and no significant difference was noted in that among permanent and non-permanent residents （P〈0.05）. Conclusion The gene chip technology can provide a basis for rapid diagnosis of drug-resistant tuberculosis, re-trea- ted patients being the main population with drug resistance.