结核耐药基因rpoB/katG/inhA早期筛查MDR-TB的临床研究  

Clinical study of early screening of drug-resistant gene rpoB/katG/inhA for MDR-TB

作　　者：冯彦军[1] 陈兴年[1] 李小红 叶志坚[1] 吴妹英[1] 王霞芳[1] FENG Yan-jun;CHEN Xing-nian;LI Xiao-hong;YE Zhi-jian;WU Mei-ying;WANG Xia-fang(Suzhou University Affiliated hffee-tious Diseases Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州市第五人民医院结核病科,江苏苏州215000 [2]苏州市第五人民医院传染病科,江苏苏州215000

出　　处：《临床肺科杂志》2018年第11期1946-1949,共4页Journal of Clinical Pulmonary Medicine

基　　金：苏州市科技局民生科技项目(No SS201656);苏州市临床重点病种诊疗技术专项(No LCZX201514);苏州市重点学科(No SZZK201514)

摘　　要：目的评估结核耐药基因rpo B/kat G/inh A筛查耐多药结核的可行性及临床意义。方法对2016年1月至2017年5月我科住院的228例肺结核患者分别采用结核耐药基因检测法和改良罗氏培养比例法检测利福平、异烟肼是否耐药,比较两种检验方法诊断的一致性。结果以改良罗氏培养比例法为金标准,228例患者中结核耐药基因检测法利福平耐药的灵敏度为88. 24%,特异度为97. 63%,异烟肼耐药的灵敏度为92. 31%,特异度为99. 01%。两法有较高的一致性(无统计学差异)。结论结核耐药基因rpo B/kat G/inh A可早期、快速、准确检测利福平、异烟肼的耐药性,可作为耐多药结核早期筛查的方法,对结核病防与治有重要意义。Objective To evaluate the feasibility and clinical significance of detection screening tuberculosis resistance gene of rpoB/katG/inhA of MDR-TB. Methods Respectively, it used tuberculosis drug resistance gene detection and modified Roche culture ratio of tuberculosis to test the resistance of Rifampiein and Isoniazid of 228 eases of tuberculosis patients from January 2016 to May 2017, and the consistency of the two test methods was compared. Results Taking modified Roche culture ratio method as the gold standard, the sensitivity of rifampiein resistance was 88.24% , the speeifieity of rifampiein resistance was 97. 63% , the sensitivity of isoniazid resistance was 92. 31% , and the specificity of isoniazid resistance was 99. 01% for tuberculosis resistance gene detection. There was a high agreement between the two methods, without no statistically significant difference. Conclusion Tuberculosis resistance gene detection method has the advantages of early, rapid and accurate in the detection of rifampiein and, isoniazid drug resistance, which can be used as a nmlti-drug tuberculosis early screening method, and has great significance on the prevention and treatment of tuberculosis.

关 键 词：结核耐药基因 耐多药结核 早期筛查 

分 类 号：R521[医药卫生—内科学] R440[医药卫生—临床医学]