微阵列芯片技术在耐多药结核病临床诊断中的应用研究

目的 探讨微阵列芯片技术在耐多药结核病（multidrug resistant tuberculosis，MDR-TB）临床诊断中的应用。方法 收集2020年6月至2021年5月经滨州市中心医院确诊的245例住院肺结核患者的标本（痰液标本125例和痰培养分离菌株120例）。痰液标本同时采用DNA微阵列芯片技术和传统培养法检测其结核杆菌阳性率。痰液标本和分离菌株均采用DNA微阵列芯片技术进行肺结核耐多药检测和分枝杆菌菌种鉴定。结果 125例痰液标本经DNA微阵列芯片技术和痰培养法检测，阳性率分别为58.4%（73/125）和24.8%（31/125），两种方法比较差异有统计学意义（2=14.520，P<0.001）。采用DNA微阵列芯片技术检测125例痰液标本和120例分离菌株，共检出结核分枝杆菌复合群192例，非结核分枝杆菌7例。结核分枝杆菌复合群192例检出耐药者41例，其中耐异烟肼15例，耐利福平19例，同时耐两种药物7例。非结核分枝杆菌包括胞内分枝杆菌4例，堪萨斯分枝杆菌2例，鸟分枝杆菌1例。结论 DNA微阵列芯片技术检测周期短，能同时进行结核分枝杆菌耐多药检测和菌种鉴定，对MDR-TB的早期诊断和治疗有较大的临床应用价值。

Application of microarray chip technology in clinical diagnosis of multidrug resistant tuberculosis

Objective To explore the application of microarray chip technology in the clinical diagnosis of multidrug resistant tuberculosis (MDR-TB). Methods Samples (125 sputum specimens and 120 strains isolated from sputum culture) were collected from 245 patients diagnosed with pulmonary tuberculosis in Binzhou Central Hospital from June 2020 to May 2021. Sputum samples were tested by DNA microarray chip technology and traditional culture method. DNA microarray chip technology was used to detect multidrug resistance and identify mycobacterium strains in sputum samples and isolated strains. Results The positive rates of 125 sputum samples were 58.4% (73/125) and 24.8% (31/125) by DNA microarray chip technology and sputum culture, respectively, and the difference between the two methods was statistically significant (2=14.520, P<0.001). Using DNA microarray chip technology, 125 sputum samples and 120 isolated strains were detected. A total of 192 mycobacterium tuberculosis complex and 7 nontuberculous mycobacteria were detected. Among 192 cases of mycobacterium tuberculosis complex, 41 cases were drug resistant, including 15 cases resistant to isoniazid, 19 cases resistant to rifampicin and 7 cases resistant to both drugs. Nontuberculous mycobacteria included 4 cases Mycobacterium intracellulare, 2 case Mycobacterium kansasii and 1 case Mycobacterium avium. Conclusion DNA microarray chip technology has a short detection cycle, can be used to detect multidrug resistance and strain identification of mycobacterium tuberculosis at the same time, and has great clinical application value for early diagnosis and treatment of MDR-TB.