中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2009年
4期
597-598
,共2页
结核,抗多种药物性%聚合酶链反应%寡核苷酸探针%基因,MDR
結覈,抗多種藥物性%聚閤酶鏈反應%寡覈苷痠探針%基因,MDR
결핵,항다충약물성%취합매련반응%과핵감산탐침%기인,MDR
Tuberculosis,multidrug-resistant%Polymerase chain reaction%Oligonueleotide probes%Gene,MDR
目的 探讨聚合酶链反应(PCR)-寡核苷酸探针检测结核菌耐药基因的临床应用价值.方法 耐多药肺结核患者80例分为观察组40例和常规组40例,应用PCR-寡核苷酸探针反向斑点杂交技术测定基因耐药情况和突变类型.结果 KatG、inhA、rpoB和embB基因突变率分别为90.9%、84.8%、51.98%和58.1%;寡核苷酸探针膜杂交检测rpoB基因突变的灵敏度为98.0%,特异度为100%,阳性预测值为82.61%,与传统药敏试验的符合率为62.50%;寡核苷酸探针膜杂交检测KatG基因突变的灵敏度为50.56%,特异度为75%,阳性预测值为68.75%,与传统药敏试验的符合率为46.43%;观察组病灶显著吸收、吸收、不变、恶化(32.5%、62.5%、5.0%、0%)均高于常规组(25.0%、50.0%、20.0%、5.0%)(χ2=3.98,χ2=3.92,P<0.05;χ2=6.78,χ2=6.80,P<0.01);观察组治疗后3个月、6个月、9个月痰菌阴转率分别为65.0%、77.5%、85.0%,高于常规组(37.5%、50.0%、60.0%)(χ2=3.86,χ2=3.85,χ2=3.89,均P<0.05).结论 寡核苷酸探针膜杂交技术一次分析可获得结核菌耐3种药物的4个基因;观察组疗效高于常规组.
目的 探討聚閤酶鏈反應(PCR)-寡覈苷痠探針檢測結覈菌耐藥基因的臨床應用價值.方法 耐多藥肺結覈患者80例分為觀察組40例和常規組40例,應用PCR-寡覈苷痠探針反嚮斑點雜交技術測定基因耐藥情況和突變類型.結果 KatG、inhA、rpoB和embB基因突變率分彆為90.9%、84.8%、51.98%和58.1%;寡覈苷痠探針膜雜交檢測rpoB基因突變的靈敏度為98.0%,特異度為100%,暘性預測值為82.61%,與傳統藥敏試驗的符閤率為62.50%;寡覈苷痠探針膜雜交檢測KatG基因突變的靈敏度為50.56%,特異度為75%,暘性預測值為68.75%,與傳統藥敏試驗的符閤率為46.43%;觀察組病竈顯著吸收、吸收、不變、噁化(32.5%、62.5%、5.0%、0%)均高于常規組(25.0%、50.0%、20.0%、5.0%)(χ2=3.98,χ2=3.92,P<0.05;χ2=6.78,χ2=6.80,P<0.01);觀察組治療後3箇月、6箇月、9箇月痰菌陰轉率分彆為65.0%、77.5%、85.0%,高于常規組(37.5%、50.0%、60.0%)(χ2=3.86,χ2=3.85,χ2=3.89,均P<0.05).結論 寡覈苷痠探針膜雜交技術一次分析可穫得結覈菌耐3種藥物的4箇基因;觀察組療效高于常規組.
목적 탐토취합매련반응(PCR)-과핵감산탐침검측결핵균내약기인적림상응용개치.방법 내다약폐결핵환자80례분위관찰조40례화상규조40례,응용PCR-과핵감산탐침반향반점잡교기술측정기인내약정황화돌변류형.결과 KatG、inhA、rpoB화embB기인돌변솔분별위90.9%、84.8%、51.98%화58.1%;과핵감산탐침막잡교검측rpoB기인돌변적령민도위98.0%,특이도위100%,양성예측치위82.61%,여전통약민시험적부합솔위62.50%;과핵감산탐침막잡교검측KatG기인돌변적령민도위50.56%,특이도위75%,양성예측치위68.75%,여전통약민시험적부합솔위46.43%;관찰조병조현저흡수、흡수、불변、악화(32.5%、62.5%、5.0%、0%)균고우상규조(25.0%、50.0%、20.0%、5.0%)(χ2=3.98,χ2=3.92,P<0.05;χ2=6.78,χ2=6.80,P<0.01);관찰조치료후3개월、6개월、9개월담균음전솔분별위65.0%、77.5%、85.0%,고우상규조(37.5%、50.0%、60.0%)(χ2=3.86,χ2=3.85,χ2=3.89,균P<0.05).결론 과핵감산탐침막잡교기술일차분석가획득결핵균내3충약물적4개기인;관찰조료효고우상규조.
Objective To investigate the clinical application of mutations drug-resistant tuberculosis (MDR-TB) by polymerase chain reaction(PCR)-oligonucleotide probes. Methods 80 cases of MDR-TB were divided into observed group 40 cases and conventional group 40 cases, the resistant gene and the type of mutation were determined by polymerase chain reaction (PCR)-oligonucleotide probes. Results 78 isolates of 4 kinds of resistance genes (KatG,inhA,rpoB,embB) ,the mutation rates were 90.9% ,84.8% ,51.98% and 58.1% ;the gene of rpoB sensitivi-ty of 98.0% and specificity of 100% ,positive predictive value of 82.61% ,the rate of according with traditional drug susceptibility testing were 62.50% by polymerase chain reaction (PCR)-oligonucleotide probes;the serisitivity of the KatG gene mutation is of 50.56% ,specificity of 75% ,positive predictive value of 68.75% ,the rate of according with traditional drug susceptibility testing were 46.43% by polymerase chain reaction (PCR)-oligonucleotide probes;the observed group in focus significant absorption, absorption, invariability, deterioration were 32.5% ,62.5% ,5.0%, 0% ,higher than the conventional group(25.0% ,50.0% ,20.0% ,5.0% ) (χ2=3.98,χ2=3.92, P<0.05;χ2=6.78,χ2=6.80,P<0.01) ;observed group in 3 months after treatment,6 months,9 months sputum the conversion negative rate in observed group (65.0%, 77.5%, 85.0% ) higher than the conventional group (37.5%, 50.0%, 60.0%) (χ2=3.86,χ2=3.85,χ2=3.89,P both<0.05). Conclusion An analysis available 3 kind of MDR-TB, 4 kind gene by PCR-oligonucleotide;the observed group in curative effect is better than the conventional group in pa-tients with MDR-TB.
