1 May 2020
Objective To analyze the characteristics of γ - interferon release test and Mycobacterium tuberculosis resistance gene, and we provide reference for clinical diagnosis and treatment of MDR-TB.
Methods Totally 49 cases of pulmonary tuberculosis (pulmonary tuberculosis group) and 51 cases of pneumonia (pneumonia group) were studied in the Second Affiliated Hospital of Hainan Medical College from January 1, 2019 to January 1, 2020, and 40 cases of health check- up were selected as control group, and the levels of Gamma interferon were detected by gamma interferon release test. At the same time, DNA microarray method was used to detect drug-resistant genes in pulmonary tuberculosis group, and the obtained data were statistically analyzed by SPSS19.0 software.
Results The positive rate of IGRA in pulmonary tuberculosis group, pneumonia group and control group was 57.1%(28/49), 29.4%(15/51) and 2.5%(1/40), respectively. The difference among the three groups was statistically significant ( P<0.01). The detection rate and mutation rate of the rpoB gene were 34.7%(17/49) and 35.3%(6/17), the common mutation sites were 531, 513, 526, 511, and the type of mutation was 531 locus (C ->T), 513 locus (C ->A), 526 locus (A ->T) and 511 locus (T ->C), respectively. The detection rate and mutation rates of katG315 gene were 34.7%(17/49) and 17.6%(3/17), and the type mutation site is AGC>ACC. IGRA positive rates of the detected and undetected rpoB genes were (82.4%, 14 / 17) and (43.8%, 14 / 32), respectively, with statistically significant differences ( P<0.01). IGRA positive rates of the detected and undetected katG315 genes were (82.4%, 14 / 17) and (46.8%, 15 / 32), respectively, with statistically significant differences ( P<0.05).
Conclusions The rpoB mutation sites are diverse, while katG315 is single. The results of combined IGRA and gene detection are more significant for the diagnosis and treatment of clinical tuberculosis.
摘要： 目的 分析 γ-干扰素释放试验 (interferon gamma release assay, IGRA) 与结核分枝杆菌耐药基因的特征性, 为 临床诊治耐多药结核提供参考依据。 方法 选取 2019 年 1 月 1 日—2020 年 1 月 1 日在海南医学院第二附属医院住院的 肺结核 49 例 (肺结核组) 和肺炎 51 例 (肺炎组) 为研究对象, 另选取同期进行健康体检者 40 例为对照组, 采用 γ-干扰素 释放试验检测 γ-干扰素水平, 同时采用 DNA 微阵列芯片法对肺结核组进行耐药基因检测, 所得数据采用 SPSS19.0 软 件进行统计学分析。 结果 肺结核组、肺炎组和对照组 IGRA 阳性率分别为 57.1% (28/49) 、29.4% (15/51) 和 2.5% (1/ 40) , 3 组差异有统计学意义 ( P<0.01) 。 rpoB 基因检出率和突变率分别为 34.7% (17/49) 和 35.3% (6/17) , 常见的突变位 点分别为 531、513、526、511, rpoB 基因突变类型分别为 531 位点 (C->T) 、513 位点 (C->A) 、526 位点 (A->T) 及 511 位点 (T->C); katG315 基因检出率和突变率分别为 34.7% (17/49) 和 17.6% (3/17) , 突变类型为 katG315 位点 AGC->ACC; 检出 和未检出 rpoB 基因的 IGRA 阳性率分别为 82.4% (14/17) 和 43.8% (14/32) , 差异有统计学意义 ( P<0.01) 。检出和未检出 katG315 基因的 IGRA 阳性率分别为 82.4% (14/17) 和 46.8% (15/32) , 差异有统计学意义 ( P<0.05) 。 结论 rpoB 突变位点 呈多样性, 而 katG315 呈单一性; 联合 IGRA 和基因的检测结果对临床结核的诊断和治疗更有意义。