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目的以基因芯片法快速筛查不同类型复治肺结核的耐药情况,为临床早期制定合理的化疗方案提供实验依据。方法对贵阳市肺科医院2013年1月-2014年6月住院的痰涂片抗酸染色阳性的复治肺结核患者,随机选择100例样本提取细菌基因组DNA后进行异烟肼、利福平耐药基因的基因芯片法检测,同时对各样本进行结核分枝杆菌分离培养和传统药敏试验。结果以传统药敏检测为标准,芯片法检测异烟肼耐药、利福平耐药和多耐药的灵敏度分别为89.2%、90.3%和91.0%,特异度均为100.0%,假阳性率均为0.0%,假阴性率分别为10.8%、9.7%和9.0%,符合率分别为92.0%、91.0%和94.0%。结论基因芯片法能快速筛查复治肺结核的耐药和耐多药情况,与传统罗氏培养药敏试验相比,具有简便、快速、灵敏度高、特异性强的优点,值得在临床中推广应用。
Objective To rapidly screen the resistance of different types of retreatment pulmonary tuberculosis by gene chip method and provide experimental basis for formulating reasonable chemotherapy regimen early in clinical practice. Methods 100 patients were randomly selected from 100 patients with sputum smear-positive acid-fast resuscitation pulmonary tuberculosis hospitalized from January 2013 to June 2014 in the Pulmonary Hospital of Guiyang City. The bacterial genomic DNA was extracted and then isoniazid and rifampicin Drug gene gene chip detection, at the same time on each sample for Mycobacterium tuberculosis isolation and culture and traditional drug sensitivity test. Results The traditional method of drug susceptibility testing was used as the standard. The sensitivity of chip method to detect isoniazid resistance, rifampicin resistance and multidrug resistance were 89.2%, 90.3% and 91.0% respectively, and the specificity was 100.0%. The false positive rate The false negative rates were 10.8%, 9.7% and 9.0%, respectively. The coincidence rates were 92.0%, 91.0% and 94.0% respectively. Conclusion The method of gene chip can rapidly screen the resistant and multi-drug resistant cases of pulmonary tuberculosis. Compared with the traditional Roche susceptibility test, the gene chip method has the advantages of simple, rapid, sensitive and specific. It is worth popularizing in the clinic .