摘要
目的 探讨基因芯片技术在获得性免疫缺陷综合征（AIDS）合并分枝杆菌感染诊断中的临床应用.方法 应用基因芯片技术对AIDS合并分枝杆菌感染者标本进行分枝杆菌种属鉴定,同时对鉴定为结核分枝杆菌的标本进行利福平及异烟肼耐药基因检测.结果 本研究共纳入136例分枝杆菌病例,其中57例为AIDS合并分枝杆菌感染者的实验组,79例同期非HIV感染的分枝杆菌感染者为对照组.实验组结核分枝杆菌（MTB）检出率为78.9%（45/57）,非结核分枝杆菌（NTM）检出率为21.1%（12/57）（其中鸟分枝杆菌10例、偶然分枝杆菌1例、癗疠分枝杆菌1例）;对照组MTB检出率为96.2%（76/79）,NTM检出率为3.8%（3/79）（其中鸟分枝杆菌2例、龟/脓肿分枝杆菌1例）.实验组NTM感染率高于对照组（P〈0.05）,且主要以鸟分枝杆菌（MAC）感染为主.进一步对鉴定为MTB的标本进行耐利福平（RIF）基因rpoB及耐异烟肼（INH）基因katG、inhA检测.实验组45例MTB阳性样本总耐药率为15.6%（7/45）,其中RIF和INH共同耐药8.9%（4/45）、单耐RIF2.2%（1/45）、单耐INH4.4%（2/45）;对照组76例MTB阳性样本,总耐药率为31.6%（24/76）,其中RIF和INH共同耐药21.1%（16/76）、单耐RIF5.3%（4/76）、单耐INH5.3%（4/76）.两组比较耐药率无明显差异.结论 基因芯片技术对AIDS合并分枝杆菌感染快速诊断及结核耐药性分析方面中具有重要价值,为临床制定合理治疗方案提供了科学依据.
Objective To investigate the clinical application of gene chip technology in the diagnosis of AIDS complicated with Mycobacterium infection.Methods Using gene chip technique of mycobacterial infection specimens were Mycobacterium species is identified,and the identification of specimens of Mycobacterium tuberculosis to rifampin and isoniazid resistant gene detection.Results This study included 136 cases of Mycobacterium tuberculosis cases,including 57 cases of AIDS complicated with Mycobacterium infection in the experimental group,79 cases of non HIV infection in the same period as the control group.The detection rate of Mycobacterium tuberculosis（MTB） in the experimental group was 78.9%（45/57）,and thedetection rate was 21.1%（12/57）of the nontuberculous Mycobacterium（NTM）.（of which 10 cases of Mycobacteria aviom-intracelluar and Mycobacterium fortuitum in 1 cases,1 cases of scrofula Mycobacterium Lei）;The detection rate of MTB in control group was 96.2%（76/79）,and the detection rate of NTM was 3.8%（3/79）（among them,2 cases of Mycobacteria aviom-intracelluar,1 cases of Mycobacterium tuberculosis and cases of Mycobacterium tuberculosis）.The infection rate of NTM in the two groups was significantly higher than that in the control group（P〈0.05）,and the main infection was mainly Mycobacteria aviom-intracelluar（MAC）.Further identification of MTB specimens were resistant to rifampicin（RIF） of rpoB gene and resistance to isoniazid（INH） katG,InhA detection.In the experimental group,the total drug resistance rate of 45 MTB positive samples was 15.6%（7/45）,among them,RIF and INH were 8.9%（4/45）and（RIF2.2%）,（1/45） and INH4.4%（2/45）;In the control group,76 cases of MTB positive samples,the total drug resistance rate was 31.6%（24/76）,including RIF and INH co drug resistance 21.1%（16/76）,single resistance to RIF5.3%（4/76）,single resistance to INH5.3%（4/76） There was no significant difference in drug resistance between the two groups.Conclusion Gene chip technology has important value in the rapid diagnosis of AIDS complicated with Mycobacterium infection and the prevention and treatment of drug resistance,provide scientific basis for the clinical development of reasonable treatment plan.
作者
谢祺
杨翠先
樊红丽
李正伦
姚之莹
罗兰芳
董兴齐
XIE Qi YANG Cui-xian L I Zheng-lun YAO Zhi-ying L UO Lan- fang DONG Xing-qi(Department of Clinical Laboratory ,Yunnan Infectious Disease Specialist Hospital ,Yunnan 650301 ,China)
出处
《检验医学与临床》
CAS
2017年第A01期151-155,共5页
Laboratory Medicine and Clinic
