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目的采用DNA微阵列芯片法检测结核分枝杆菌INH耐药基因,为临床诊治提供实验依据。方法应用DNA微阵列芯片法和改良罗氏培养加比例法药敏试验对疑似结核病患者的150份痰液标本进行检测,并对检测的结果进行比较分析。结果 150份痰液标本的涂阳率为60.0%(90/150),DNA微阵列芯片法检测到结核分枝杆菌阳性率为62.7%(94/150),改良罗氏培养法阳性率为60.0%(90/150),比例法药敏试验异烟肼的耐药率为43.9%(36/82),异烟肼的kat G/inh A基因总突变率为35.1%(33/94);以改良罗氏培养加比例法药敏试验为标准,DNA微阵列芯片法检测结核分枝杆菌阳性、异烟肼耐药性和敏感性的符合率分别为97.7%、86.1%和100.0%。结论 DNA微阵列法可快速准确地检测大部分疑似结核病临床标本的kat G和inh A基因突变,可用于临床耐药性的检测从而指导临床用药,也可用于临床诊断中的推广。
Objective To detect the INH resistance gene of Mycobacterium tuberculosis by DNA microarray and provide experimental evidence for clinical diagnosis and treatment. Methods DNA microarray chip method and modified Roche culture plus proportional susceptibility test were used to detect sputum samples of 150 suspected tuberculosis patients and the results were compared. Results The sputum smear positive rate was 60.0% (90/150). The positive rate of Mycobacterium tuberculosis detected by DNA microarray was 62.7% (94/150), the positive rate of modified Roche culture was 60.0% (90/150). The resistance rate of isoniazid was 43.9% (36/82) in proportional susceptibility test and 35.1% (33/94) in isoniazid test. Modified Roche culture plus proportional susceptibility test as a standard, DNA microarray detection of Mycobacterium tuberculosis positive, isoniazid resistance and sensitivity were 97.7%, 86.1% and 100.0%, respectively. Conclusion The DNA microarray method can rapidly and accurately detect kat G and inh A gene mutations in most suspected TB samples, and can be used in the detection of clinical drug resistance to guide the clinical use of drugs and in clinical diagnosis.