结核分枝杆菌表型及基因型一致性与患者预后的相关性研究

Study on the consistency of phenotypc and genotype of Mycobacterium tuberculosis in the prognosis of patients

目的对结核分枝杆菌耐药表型与基因型的一致性进行分析，包括了四种一线抗结核药物（异烟肼、利福平、乙胺丁醇、链霉素），探讨其一致性是否与疾病预后相关，为临床治疗提供依据=方法选择2009年5月至2015年10月本结核科收治的49例肺结核患者，按照临床预后分为有效组和无效组，收集患者治疗期间的结核分枝杆菌临床菌株，分别进行结核分枝杆菌药敏试验（表型检测）和聚合酶链式反应（PCR）-反向斑点杂交法快速检测结核分枝杆菌耐药基因（基因型检测）检测。对两种检测方法一致性进行检验.探讨两种检测方法的一致性是否与疾病预后相关。结果按照临床疗效分组提示四种一线抗结核药物（异烟肼、利福平、乙胺丁醇、链霉素）两种检测一致性无效组低于有效组。相对于其他抗结核药物利福平两种检测一致性差。结论结核杆菌突变位点的稳定性与疾病的预后正相关，相对其他抗结核药物，利福平的稳定性最差。

Objective Regarding the bacterial strains of 49 patients with pulmonary tuberculosis,phenotypic and genotypic detections of drug sensitivity were done for rifampicin, isoniazide, ethambutol, and streptomycin. To explore whether its consistency was related to the prognosis of disease and to provide evidence for clinical treatment. Methods For the 49 patients with pulmonary tuberculosis who were received by the Tuberculosis Department from May 2009 to October 2015,their 98 clinically isolated mycobacteria tuberculosis were collected. Next, drug sensitive test was done for mycobacteria tuberculosis and polymerase chain reaction （PCR） reverse dot-blot hybridization was adopted to quickly detect the drug resistance genes of mycobacteria tuberculosis. Based on the clinical prognosis, the patients were divided into the effective group and the ineffective group, with consistency examination on the two detection methods. Next, to explore whether its consistency was related to the prognosis of disease. Results The phenotypic detections and the genotypic detections of rifampicin showed poor consistency in the test. Regarding the effective group, its consistency for the detections of drugs was higher than that of the ineffective group. Conclusions The stability of mutation sites of mycobacteria tuberculosis is connected with the prognosis of diseases.