基因芯片技术在鉴定分枝杆菌属及早期诊断耐药结核中的价值分析

摘要

Objective To investigate the gene chip technique in identification of mycobacterial genus and clinical value of early diagnosis of drug-resistant tuberculosis.Method Gene chip technology had been applied to check alveolar irrigation lavage and sputum specimens of patients, which each case was 60. With the traditional culture and drug sensitivity test as the gold standard, drug resistance of the positive mycobacterium tuberculosis sample was analyzed, and the coincidence rate was contrasted.Result 120 samples were detected by gene chip technique, mycobacterium tuberculosis was isolated from 39 cases (24 cases of irrigating solution, 15 cases of sputum), and mycobacterium non-tuberculosis was isolated from 2 cases of irrigating solution sample. The hybridization result of 10 cases drug sensitive of mycobacterium tuberculosis which detected by gene chip technique was exactly the same as standard strains;rpoBgene mutation were detected from 15 cases of Nailifu resistance mycobacterium tuberculosis;KatGgene mutation were detected from 22 cases of Yiyanjin resistance mycobacterium tuberculosis, andinhAgene mutation were detected from 3 cases of Yiyanjin resistance mycobacterium tuberculosis. With the results of traditional drug susceptibility test as a standard, the coincidence rate of Nailifu resistance, Yiyanjin resistance and multi drug resistance was 93.7%(15/16), and 92.6%(25/27), and 84.6%(11/13) respectively which detected by gene chip technique.Conclusion Gene chip technology could directly use to identify mycobacterium species and analyze drug resistance, which have good consistency with traditional drug susceptibility testing methods and is suitable for various specimens. With simple and rapid, high sensitivity, specificity, it is worth clinical application.%目的：探讨基因芯片技术在鉴定分枝杆菌属及早期诊断耐药结核中的临床运用价值。方法应用基因芯片技术对患者肺泡灌洗液及痰液标本各60例进行检测，对结核分枝杆菌阳性标本进行耐药性分析，以传统培养加药敏试验为金标准，对比符合率。结果应用基因芯片技术检测120例标本，39例标本分离出结核分枝杆菌（灌洗液24例，痰液15例），2例灌洗液标本分离出非结核分枝杆菌。10例药物敏感结核分枝杆菌基因芯片杂交结果与标准株完全相同；15例利福耐药株中检测到rpoB基因突变；25例异烟肼耐药株中有22例检测到KatG基因突变，3例检测到inhA基因突变。以传统药物敏感试验结果为标准，基因芯片法检测利福平、异烟肼耐药和耐多药的符合率分别为93.7%（15/16）、92.6%（25/27）、84.6%（11/13）。结论基因芯片技术可以直接进行分枝杆菌菌属鉴定及耐药性分析，其与传统药敏试验方法有很好的一致性，且可适用不同标本。其具有简捷快速，灵敏度高、特异性好的特点，值得临床应用。