中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2008年
2期
182-184
,共3页
郑如添%庄穗香%张志军%刘集鸿
鄭如添%莊穗香%張誌軍%劉集鴻
정여첨%장수향%장지군%류집홍
分支杆菌,结核%药物耐受性%耐药基因%聚合酶链反应
分支桿菌,結覈%藥物耐受性%耐藥基因%聚閤酶鏈反應
분지간균,결핵%약물내수성%내약기인%취합매련반응
Mycobacterium tuberculosis%Drugresistance%Drug resistancegene%Polymerase chain reaction
目的 分析肺结核患者结核分支杆菌获得性耐药情况,比较两种耐药性检测方法的检测效果.方法 用药敏试验(绝对浓度法)检测结核分支杆菌株对利福平(RFP)、异烟肼(INH)、链霉素(SM)、吡嗪酰胺(PZA)和乙胺丁醇(EMB)的耐药情况,采用聚合酶链反应-单链构象多态性分析(PCR-SSCP)检测结核分支杆菌耐药rpoB、katG、rpsL、pncA和embB基因突变.结果:400例肺结核耐药患者常规药敏试验耐药316例(79.8%);耐药基因检测耐药株288株,突变率72.0%.RFP耐药例数和耐药率明显高于SM、PZA和EMB(耐药例数:F=2.45,2.56,2.69,P＜0.05;耐药率:F=2.55,2.66,2.79,P＜0.05),rpoB突变株和突变率明显高于katG、rpsL、pncA和embB(突变株:F=2.28,2.46,3.19,3.33,P＜0.05～0.01;突变率:F=2.36,2.61,3.25,3.45,P＜0.05～0.01),高浓度药物耐药菌株的突变株和突变率显著高于低浓度药物耐药菌株,随着不规律用药时间的延长,耐药率和突变率均逐渐上升(耐药率:F=2.77,2.88,P＜0.05;突变率:F=2.72,2.85,P＜0.05).结论 PCR-SSCP是一种快速检测结核杆菌rpoB、katG、rpsL、pncA和embB基因突变敏感、特异的方法.
目的 分析肺結覈患者結覈分支桿菌穫得性耐藥情況,比較兩種耐藥性檢測方法的檢測效果.方法 用藥敏試驗(絕對濃度法)檢測結覈分支桿菌株對利福平(RFP)、異煙肼(INH)、鏈黴素(SM)、吡嗪酰胺(PZA)和乙胺丁醇(EMB)的耐藥情況,採用聚閤酶鏈反應-單鏈構象多態性分析(PCR-SSCP)檢測結覈分支桿菌耐藥rpoB、katG、rpsL、pncA和embB基因突變.結果:400例肺結覈耐藥患者常規藥敏試驗耐藥316例(79.8%);耐藥基因檢測耐藥株288株,突變率72.0%.RFP耐藥例數和耐藥率明顯高于SM、PZA和EMB(耐藥例數:F=2.45,2.56,2.69,P＜0.05;耐藥率:F=2.55,2.66,2.79,P＜0.05),rpoB突變株和突變率明顯高于katG、rpsL、pncA和embB(突變株:F=2.28,2.46,3.19,3.33,P＜0.05～0.01;突變率:F=2.36,2.61,3.25,3.45,P＜0.05～0.01),高濃度藥物耐藥菌株的突變株和突變率顯著高于低濃度藥物耐藥菌株,隨著不規律用藥時間的延長,耐藥率和突變率均逐漸上升(耐藥率:F=2.77,2.88,P＜0.05;突變率:F=2.72,2.85,P＜0.05).結論 PCR-SSCP是一種快速檢測結覈桿菌rpoB、katG、rpsL、pncA和embB基因突變敏感、特異的方法.
목적 분석폐결핵환자결핵분지간균획득성내약정황,비교량충내약성검측방법적검측효과.방법 용약민시험(절대농도법)검측결핵분지간균주대리복평(RFP)、이연정(INH)、련매소(SM)、필진선알(PZA)화을알정순(EMB)적내약정황,채용취합매련반응-단련구상다태성분석(PCR-SSCP)검측결핵분지간균내약rpoB、katG、rpsL、pncA화embB기인돌변.결과:400례폐결핵내약환자상규약민시험내약316례(79.8%);내약기인검측내약주288주,돌변솔72.0%.RFP내약례수화내약솔명현고우SM、PZA화EMB(내약례수:F=2.45,2.56,2.69,P＜0.05;내약솔:F=2.55,2.66,2.79,P＜0.05),rpoB돌변주화돌변솔명현고우katG、rpsL、pncA화embB(돌변주:F=2.28,2.46,3.19,3.33,P＜0.05～0.01;돌변솔:F=2.36,2.61,3.25,3.45,P＜0.05～0.01),고농도약물내약균주적돌변주화돌변솔현저고우저농도약물내약균주,수착불규률용약시간적연장,내약솔화돌변솔균축점상승(내약솔:F=2.77,2.88,P＜0.05;돌변솔:F=2.72,2.85,P＜0.05).결론 PCR-SSCP시일충쾌속검측결핵간균rpoB、katG、rpsL、pncA화embB기인돌변민감、특이적방법.
Objective To investigate drug resistance of mycobacterium tuberculosis,compare detecting effect of two methods and evaluate their value of clinical application.Methods All of the strains of mycoba-cterium tuberculosis were tested for resistance to RFP,INH,SM,PZA and EMB by the absolute concentration method on lowenste in-jensen medium and the mutation of the rpoB,katG,rpsL,pncA and embB resistanc genes in mycobacterium.Tuberculosis was tested by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP).Results 400 cases of tuberculosis drug resistance in patients with conventional susceptibility test resistance 316 cases (79.8%);resistant strains resistant gene detection 288,the mutation rate(72.0%):the RFP cases of resistance and resistance was significantly higher than that of SM,PZA and the EMB(resistant cases:F=2.45,2.56,2.69,P＜0.05;ResNtance:F=2.55,2.66,2.79,P＜0.05);the mutants and mutation rate of rpoB was higher than that of katG,rpsL,rpoB and embB(mutant:F=2.28,2.46,3.19,3.33,P＜0.05～O.01;mutation rate:F=2.36,2.61,3.25,3.45,P＜0.05～0.01);the gene mutation rate was higher in strains isolated from high concentration resistance than those in strains isolated from low concentration resistance;the more irregular treatment was longer,the rate of drug-resistant was higher(resistance:F=2.77,2.88,P＜0.05;mutation rate:F=2.72,2.85,P＜0.05).Conclusion PCR-SSCP is a sensitive and specific method for rapid detecting rpoB,katG,rpsL,pncA and embB gene mutations of mycobacterium tuberculosis.
