异烟肼耐药肺结核患者对丙硫异烟胺和对氨基水杨酸的耐药情况分析  

Resistance of prothionamided and sodium aminosalicylate among isoniazid resistant pulmonary tuberculosis patients

作　　者：马婷婷 任斐 马进宝 杨翰 MA Ting-ting;REN Fei;MA Jin-bao;YANG Han(Department of Gynecology and Pediatric Tuberculosis,Xi’an Chest Hospital,Xi’an 710100,China)

机构地区：[1]西安市胸科医院妇儿结核科,710100 [2]西安市胸科医院耐药结核科,710100 [3]西安市胸科医院检验科,710100

出　　处：《中国防痨杂志》2021年第9期961-964,共4页Chinese Journal of Antituberculosis

摘　　要：目的分析异烟肼(INH)耐药肺结核患者对丙硫异烟胺(Pto)和对氨基水杨酸(PAS)的耐药情况,并分析inhA基因突变与Pto耐药的相关性。方法采用回顾性分析的方法,收集2018年1月1日至2020年12月31日就诊于西安市胸科医院且符合入组标准的849例INH耐药肺结核患者对Pto和PAS的耐药资料及INH耐药基因(PCR熔解曲线法)。采用Kappa一致性检验进行inhA基因突变与Pto耐药的相关性分析。结果 849例INH耐药肺结核患者中,Pto的耐药率为3.89%(33/849),PAS的耐药率为11.90%(101/849)。518例行PCR熔解曲线检测INH耐药基因的患者中,katG基因突变率为73.75%(382/518),inhA基因突变率为15.83%(82/518),Pto耐药率为3.86%(20/518);82例inhA基因突变者中,Pto耐药7例(8.54%),与Pto耐药者中发生inhA基因突变者(35.00%,7/20)的一致性较差(Kappa=0.080)。结论 INH耐药肺结核对Pto的耐药率较低,对PAS的耐药率较高;inhA基因突变与Pto耐药的发生一致性较差。Objective To analyze the resistance of prothionamide(Pto)and sodium phenyl aminosalicylate(PAS)in patients with isoniazid(IHN)-resistant pulmonary tuberculosis(PTB),and the correlation of inhAgenes and Pto resistance. Methods We retrospectively collected data of 849 PTB patients diagnosed as INH resistant by960 liquid drug susceptibility test(DST)in Xi’an Chest Hospital from Jan 1,2018 to Dec 31,2020.The DST results of rifampicin,Pto,PAS,and mutation of katGand inhAgene were analyzed.The correlation of inhAand Pto resistance was examined with Cohen’s Kappatest. Results In 849 cases of INH resistant patients,33 cases were resistant to Pto,the drug resistance rate was 3.89%(33/849).One hundred and one patients were resistant to PAS,the drug resistance rate was 11.90%.Among 518 patients with INH resistance related gene detected by real-time PCR fusion curve test,the mutation rate of katG and inhA gene were 73.75%(382/518)and 15.83%(82/518)respectively,the drug resistance rate of Pto was 3.86%(20/518).Among 82 patients with inhA gene mutation,the drug resistance rate of Pto was 8.54%(7/82),while the inhA mutation rate among Pto resistant patients was 35.00%(7/20),their consistency was poor(Kappa=0.080).Conclusion The resistance rate of Pto among INH resistant patients was low,while resistance rate of PAS was high.The consistency of Pto resistance and inhA mutation was poor.

关 键 词：分枝杆菌 结核 抗药性 细菌 评价研究 丙硫异烟胺 对氨水杨酸 

分 类 号：R521[医药卫生—内科学]