[1]崔俊伟,蔡瑞艳,王永亮.分子线性探针杂交法在结核分枝杆菌耐药性快速检测中的应用价值[J].新乡医学院学报,2017,34(10):920-923.[doi:10.7683/xxyxyxb.2017.10.014]
　CUI Jun-wei,CAI Rui-yan,WANG Yong-liang.Application value of molecular linear probe hybridization in rapid detection of drug resistance of Mycobacterium tuberculosis[J].Journal of Xinxiang Medical University,2017,34(10):920-923.[doi:10.7683/xxyxyxb.2017.10.014]
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分子线性探针杂交法在结核分枝杆菌耐药性快速检测中的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年10
页码:
920-923
栏目:
临床研究
出版日期:
2017-10-05

文章信息/Info

Title:
Application value of molecular linear probe hybridization in rapid detection of drug resistance of Mycobacterium tuberculosis
作者:
崔俊伟; 蔡瑞艳; 王永亮
（新乡医学院第一附属医院结核内一科，河南　卫辉　453100）
Author(s):
CUI Jun-wei; CAI Rui-yan; WANG Yong-liang
（Department of No.1 Tuberculosis，the First Affiliated Hospital of Xinxiang Medical University，Weihui 453100，Henan Province，China）
关键词:
分子线性探针杂交法; 结核分枝杆菌; 快速检测; 耐药性
Keywords:
molecular linear probe hybridization; Mycobacterium tuberculosis; rapid detection; drug resistance
分类号:
R521
DOI:
10.7683/xxyxyxb.2017.10.014
文献标志码:
A
摘要:
目的　探讨分子线性探针杂交法在快速检测结核分枝杆菌耐药性中的效果。方法　选择新乡医学院第一附属医院住院治疗的结核患者的临床标本750例，其中结核分枝杆菌临床分离株190例，痰涂片阳性标本560例。所有临床标本分别采用传统方法及分子线性探针杂交法进行检测，对2种方法检测的异烟肼（INH）和利福平（RFP）的耐药结果进行比较，采用分子线性探针杂交法对耐药菌株进行基因分型，分析INH及RFP耐药相关突变位点情况。结果　传统方法检测中，560例痰涂片阳性标本中共检测出结核分枝杆菌454例，其对INH、RFP耐药率分别为15.0%（68/454）、17.8%（81/454），190例结核分枝杆菌临床分离株对INH、RFP的耐药率分别为26.8%（51/190）、18.4%（35/190）;传统方法检测的结核分枝杆菌对INH、RFP的耐药率分别为18.5%（119/644）、18.0%（116/644）。分子线性探针杂交法检测454例结核分枝杆菌对INH、RFP的耐药率分别为14.1%（64/454）、17.6%（80/454），190例结核分枝杆菌临床分离株对INH、RFP的耐药率分别为23.2%（44/190）、16.3%（31/190）;分子线性探针杂交法检测的对INH、RFP的总耐药率分别为16.8%（108/644）、17.2%（111/644）。2种方法检出的结核分枝杆菌对INH、RFP的耐药率比较差异无统计学意义（INH：χ2=0.140、0.691、0.650;RFP：χ2=0.011、0.293、0.131;P>0.05）。分子线性探针杂交法检测中，对INH和RFP的灵敏度、特异度分别为85.7%、98.9%和90.5%、98.9%，其中katG-S315T1为INH耐药主要突变位点，约占88.9%，rpoB-S531L为RFP耐药主要突变位点，约占81.1%。结论　分子线性探针杂交法能够快速检测出结核菌株和痰标本中结核分枝杆菌的耐药性，并能对耐药基因进行分型，减少药物敏感性试验的时间，并能根据药物敏感性结果尽快采取有效的治疗方案。
Abstract:
Objective　To explore the application value of molecular linear probe hybridization in rapid detection of drug resistance of Mycobacterium tuberculosis.Methods　Seven hundred and fifty clinical samples of patients with tuberculosis were selected from the First Affiliated Hospital of Xinxiang Medical University，including 190 cases of clinical isolation of Mycobacterium tuberculosis and 560 cases of sputum smear positive samples.All the samples were detected by traditional method and molecular linear probe hybridization respectively.The results of drug resistance test of isoniazid（INH） and rifampicin（RFP） detected by the two methods were compared，the genotyping of drug resistant strain were detected by molecular linear probe hybridization and resistance related mutable site of INH and RFP were analyzed.Results　By the traditional method，four hundred and fifty-four cases of Mycobacterium tuberculosis were detected in 560 cases of sputum smear positive specimens，the drug resistance rate of INH and RFP was 15.0%(68/454) and 17.8%(81/454) respectively.The drug resistance rate of INH and RFP in the four hundred and fifty-four cases of Mycobacterium tuberculosis was 26.8%(51/190) and 18.4%(35/190) respectively in 190 cases of clinical isolation of Mycobacterium tuberculosis，the total drug resistance rate of INH and RFP was 18.5%(119/644) and 18.0%(116/644) respectively.By the method of molecular linear probe hybridization，the drug resistance rate of INH and RFP of 454 cases of Mycobacterium tuberculosis was 14.1%(64/454) and 17.6%(80/454) respectively，the drug resistance rate of INH and RFP was 23.2%(44/190) and 16.3%(31/190) respectively in 190 cases of clinical isolation of Mycobacterium tuberculosis，the total drug resistance rate of INH and RFP was 16.8%(108/644) and 17.2%(111/644) respectively.There was no significant difference in the drug resistance rates between the two methods （INH：χ2=0.140，0.691，0.650;RFP：χ2=0.011，0.293，0.131;P>0.05）.The sensitivity and specificity of INH and RFP was 85.7%，98.9% and 98.9% respectively in the detection of molecular linear probe hybridization，among them，katG-S315T1 was the main mutation sites of INH，accounting for about 88.9%，and rpoB-S531L was the main mutation site of RFP，accounting for about 81.1%.Conclusion　Molecular linear probe hybridization is able to quickly detect the resistance of Mycobacterium tuberculosis and Mycobacterium tuberculosis in sputum specimens，and it is able to decrease the time of drug sensitivity test by classifying the drug resistant genes，doctors can take effective treatment plan as soon as possible according to drug sensitivity results.

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更新日期/Last Update: 2017-10-05