遵义地区肺结核合并糖尿病患者发生利福平耐药的基因突变研究

Study on the gene mutations of rifampicin resistance in pulmonary tuberculosis patients combined with diabetes in Zunyi area

目的了解遵义地区肺结核(TB)合并糖尿病(DM)患者发生利福平(RIF)耐药的相关基因分子特征。方法通过结核分枝杆菌(MTB)-DNA、MTB-RNA和抗酸染色(结果均为阳性)筛选出该地区763例TB患者,根据是否合并DM分为TB组(n=525)和DM合并TB组(n=207)。经聚合酶链式反应(PCR)-反向点杂交法检测耐药相关基因rpoB,对比分析两组基因突变特点;并搜集相关临床资料以探讨其与RIF耐药发生的相关性。结果TB组患者中有52例发生RIF耐药,DM合并TB组患者中有29例发生RIF耐药。DM合并TB组发生RIF耐药突变时,ropBS531L位点突变率(51.72%)和ropB531位点突变率(44.83%)均低于TB组(分别为59.62%、57.69%),但差异均无统计学意义(P>0.05)。结论遵义地区TB患者突变位点以ropB531与ropBS531L为主,且易相伴发生;40~<65岁患者更易发生DM合并TB。

Objective To understand the molecular characteristics of rifampicin(RIF)resistance in patients with pulmonary tuberculosis(TB)and diabetes(DM)in Zunyi area.Methods 763 cases TB patients in the area were screened out by Mycobacterium tuberculosis(MTB-DNA),MTB-RNA and acid-fast staining(the results were all positive),and they were divided into TB group(n=525)and DM-TB group(n=207)according to whether they had DM.The resistance-related gene rpoB was detected by polymerase chain reaction(PCR)-reverse dot hybridization,and the characteristics of the two groups of gene mutations were compared and analyzed;relevant clinical data was collected to explore its correlation with the occurrence of RIF resistance.Results 52 cases patients in the TB group developed RIF resistance,and 29 cases patients in the DM-TB group developed RIF resistance.When RIF resistance mutations occurred in the DM-TB group,the ropBS531L site mutation rate(51.72%)and the ropB531 site mutation rate(44.83%)were lower than the TB group(respectively were 59.62%,57.69%),but the differences were not statistically significant(P>0.05).Conclusion Rifampicin resistance in TB patients in Zunyi are mainly ropB531 and ropBS531L mutations,And it is easy to occur concomitantly;patients between 40-<65 years of age are more likely to develop DM and TB.