尘肺结核患者Mycobacterium tuberculosis耐药基因突变研究  

The Study on Mutation of Drug Resistant Genes of Mycobacterium Tuberculosis in Cases of Pneumoconiosis Patients Complicated with Tuberculosis

作　　者：陆军[1] 叶松[1] 

机构地区：[1]安徽理工大学医学院,安徽淮南232001

出　　处：《安徽理工大学学报（自然科学版）》2007年第1期59-62,共4页Journal of Anhui University of Science and Technology:Natural Science

基　　金：安徽省教育厅自然科学研究资助项目(2005kj238);2005年安徽理工大学青年科学研究基金资助项目

摘　　要：研究尘肺结核患者结核分枝杆菌(Mycobacterium tuberculosis,MTB)耐药基因突变与耐药性的关系。在97例尘肺结核患者痰中检出MTB菌株28株,采用PCR-SSCP法检测katG、rpoB和rpsL基因突变,并与采用常规药敏试验(AST)法检测的耐药结果进行对比分析。采用PCR-SSCP法检测katG、rpoB和rpsL基因,突变率分别为42.86%(12/28)、42.86%(12/28)和32.14%(9/28),采用AST法检测INH、RFP和SM,耐药率分别为64.23%(18/28)、60.71%(17/28)和53.57%(15/28),两者之间差异均无显著性(P>0.05)。其中多耐药株20例(71.43%),包括耐三种药物12例(42.86%),耐两种药8例(28.57%),单耐药株6例(21.43%),敏感株2例,耐药率92.86%。PCR-SSCP法检出3个基因联合突变8株,与AST法符合率为66.67%(8/12);2个基因突变5株,符合率为62.50%(5/8);单基因突变2株,符合率为33.33%(2/6)。结果表明:PCR-SSCP技术适用于MTB katG、rpoB和rpsL耐药基因突变的筛选,对指导尘肺结核患者临床用药上具有重要意义。To study the relationship between drug resistant genetic mutation and drug-resistance to Mycobacterium tuberculosis. A total of 28 clinical isolated strains of MTB were collected from 97 pneumoconiosis patients. The genes mutation of katG,rpoB and rpsL were detected by PCR--SSCP, and the results were compared with those by traditional antimicrobial susceptibility test （AST）. The results of katG ,rpoB and rpsL by PCR-SSCP assay were 42.86% （12/28） ,42.86% （12/28） and 32.14% （9/280）, and those of INH, RFP and SM by AST were 64.23%（18/28）, 60. 71%（17/28） and 53. 57%（15/28）. Among multi-drug resistant strains were 20（71.43%） （P〉0.05）, including 12 strains （42.86%） resisting to 3 kinds of drugs, 8 strains （28. 57%） to 2 kinds of drugs and 6（21.43%） to single drug, but 2 kinds of sensitive strains. The rate of total drug-resistance was 92.86%. There were 8 strains in allied mutation of three genes, 5 in two mutations and 2 in single mutation by PCR-SSCP. The coincidences were 66.67%, 62. 50% and 33.33% respectively. The detecting rate of resistant strains in MTB is high by PCR-SSCP. PCR-SSCP technique has higher sensibility and specificity to detect to the genes of katG, rpoB and rpsL, and better advantages at guidance of clinical medications.

关 键 词：结核 结核分枝杆菌 耐药 KATG基因 RPOB基因 RPSL基因 聚合酶链反应-单链构象多态性分析 药物敏感试验 

分 类 号：R135.2[医药卫生—劳动卫生]