L型结核菌及rpoB基因检测对复治肺结核诊断价值

目的探讨L型结核分枝杆菌(MTB-L)及rpoB基因突变检测对复治肺结核诊断价值。方法对265例确诊肺结核患者痰标本进行MTB-L培养,其中初治肺结核143例,复治肺结核123例。对培养到的24例初治肺结核和52例复治肺结核患者MTB-L临床分离株进行药敏试验,并采用PCR和PCR-DS技术进行rpoB基因检测和序列分析。结果初治和复治肺结核MTB-L培养阳性率分别为16.78%(24/143)和42.28%(52/123),药敏结果提示初治和复治肺结核MTB-L对利福平耐药率分别为10.25%(3/24)和46.35%(24/52),28株L型结核分枝杆菌对利福平耐药,其中20株(71.4%)L型结核分枝杆菌rpoB基因发生突变。初治和复治肺结核MTB-L的rpoB基因突变率分别为为4.17%(1/24)和40.38%(21/52)。结论复治肺结核MTB-L检出率明显高于初治肺结核(P<0.05),复治肺结核MTB-L的rpoB基因突变率高于初治肺结核(P<0.05),L型结核菌及rpoB基因检测对复治肺结核诊断有较大价值。

Study the diagnostic value of mycobacterial L forms and rpoB genes mutations in the second-treated tuberculosis patients

Objective To study the diagnostic value of mycobacterial L forms（MTB-L） and rpoB genes mutations in the second-treated tuberculosis patients.Methods The culture of MTB-L in sputum specimen of 265 pulmonary tuberculosis,consist of 143 the first-treated patients and 123 second-treated patients.the rpoB genes mutation clinical isolated strains of MTB-L were detecting by PCR DS.Results The positive rate of MTB-L in first-treated patients and second-treated patients 16.78% and 42.28%.The rpoB gene mutation rate of first-treated patients and second-treated patients 4.17% and 40.38%.Conclusion The positive rate of MTB-L and The rpoB genes mutation clinical isolated strains of MTB-L in second-treated patients was higher,It has an major value of MTB-L and rpoB genes mutations in the diagnose of second-treated tuberculosis patients.