基因芯片与罗氏绝对浓度法对结核分枝杆菌耐药检测的效果比较

Comparison of effects of gene chips and Roche absolute concentration method for detecting Mycobacterium tuberculosis drug resistance

目的探讨基因芯片与罗氏绝对浓度法检测结核分枝杆菌耐药性的效果。方法对2012~2013年收集的180例标本进行痰液结核分枝杆菌培养,采用基因芯片检测抗结核药利福平和异烟肼的耐药性,同时采用罗氏绝对浓度法药敏检测进行对照,评价其灵敏度、特异度和符合率。结果以罗氏绝对浓度法作为金标准,基因检测结果显示,利福平耐药性的灵敏度为92.3%、特异度为97.1%、准确度为95.0%;而异烟肼的灵敏度为85.4%、特异度为93.9%、准确度为90.0%。基因检测结果显示,利福平存在rpoB基因突变,异烟肼可能存在inhA、katG和ahpC基因突变。结论基因芯片法和罗氏绝对浓度法对利福平和异烟肼耐药性检测具有较好的一致性,但基因芯片更具快速、准确的特点,值得临床推广应用。

Objective To investgate the effects of gene chips and Roche absolute concentration method for detecting Mycobacterium tuberculosis drug resistance.Methods Totally 180 sputum samples collected during 2012-2013 were performed the Mycobacterium tuberculosis culture.The gene chips were used to detect the resistance to rifampin and isoniazid,meanwhile the Roche absolute concentration method was used to conduct the drug susceptibility test as control.The sensitivity,specificity and coincidence rate were evaluated.Results With the Roche absolute concentration method as the gold standard,the genetic test results showed that the sensitivity,specificity and accuracy of rifampicin resistance were 92.3% 97.1% and 95.0% respectively;and those of isoniazid were 85.4%,93.9% and90.0% respectively.The genetic test results showed that rpoB gene mutation existed in rifampicin,and inhA,katG and ahpC mutations could exist in isoniazid.Conclusion The gene chip and Roche absolute concentration method for detecting rifampin and isoniazid resistance has better consistency,but the gene chip is faster and more accurate,which is worthy of clinical promotion and application.