Résumé
Objective To investigate the clinical application of mutations drug-resistant tuberculosis (MDR-TB) by polymerase chain reaction(PCR)-oligonucleotide probes. Methods 80 cases of MDR-TB were divided into observed group 40 cases and conventional group 40 cases, the resistant gene and the type of mutation were determined by polymerase chain reaction (PCR)-oligonucleotide probes. Results 78 isolates of 4 kinds of resistance genes (KatG,inhA,rpoB,embB) ,the mutation rates were 90.9% ,84.8% ,51.98% and 58.1% ;the gene of rpoB sensitivi-ty of 98.0% and specificity of 100% ,positive predictive value of 82.61% ,the rate of according with traditional drug susceptibility testing were 62.50% by polymerase chain reaction (PCR)-oligonucleotide probes;the serisitivity of the KatG gene mutation is of 50.56% ,specificity of 75% ,positive predictive value of 68.75% ,the rate of according with traditional drug susceptibility testing were 46.43% by polymerase chain reaction (PCR)-oligonucleotide probes;the observed group in focus significant absorption, absorption, invariability, deterioration were 32.5% ,62.5% ,5.0%, 0% ,higher than the conventional group(25.0% ,50.0% ,20.0% ,5.0% ) (χ2=3.98,χ2=3.92, P<0.05;χ2=6.78,χ2=6.80,P<0.01) ;observed group in 3 months after treatment,6 months,9 months sputum the conversion negative rate in observed group (65.0%, 77.5%, 85.0% ) higher than the conventional group (37.5%, 50.0%, 60.0%) (χ2=3.86,χ2=3.85,χ2=3.89,P both<0.05). Conclusion An analysis available 3 kind of MDR-TB, 4 kind gene by PCR-oligonucleotide;the observed group in curative effect is better than the conventional group in pa-tients with MDR-TB.
Résumé
Objective To investigate drug resistance of mycobacterium tuberculosis,compare detecting effect of two methods and evaluate their value of clinical application.Methods All of the strains of mycoba-cterium tuberculosis were tested for resistance to RFP,INH,SM,PZA and EMB by the absolute concentration method on lowenste in-jensen medium and the mutation of the rpoB,katG,rpsL,pncA and embB resistanc genes in mycobacterium.Tuberculosis was tested by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP).Results 400 cases of tuberculosis drug resistance in patients with conventional susceptibility test resistance 316 cases (79.8%);resistant strains resistant gene detection 288,the mutation rate(72.0%):the RFP cases of resistance and resistance was significantly higher than that of SM,PZA and the EMB(resistant cases:F=2.45,2.56,2.69,P＜0.05;ResNtance:F=2.55,2.66,2.79,P＜0.05);the mutants and mutation rate of rpoB was higher than that of katG,rpsL,rpoB and embB(mutant:F=2.28,2.46,3.19,3.33,P＜0.05～O.01;mutation rate:F=2.36,2.61,3.25,3.45,P＜0.05～0.01);the gene mutation rate was higher in strains isolated from high concentration resistance than those in strains isolated from low concentration resistance;the more irregular treatment was longer,the rate of drug-resistant was higher(resistance:F=2.77,2.88,P＜0.05;mutation rate:F=2.72,2.85,P＜0.05).Conclusion PCR-SSCP is a sensitive and specific method for rapid detecting rpoB,katG,rpsL,pncA and embB gene mutations of mycobacterium tuberculosis.
Résumé
Objective To discuss the changes of quality of life and influence factors in patients with multidrugresistant pulmonary tuber-culosis. Methods Using the SF-36 scale of 80 normal subjects and 80 cases of MDRTB patients before and after treatment and quality of life score total score evaluated dimensions. Results Between the patients with MDR-TB and the control in the total Qol scores and eight dimensionality, there were significant differences(P＜0.01), total Qol scores and eight dimensionality in 3 months or 1 year after treatment were higher than before therapy,there were significant differences(P＜0.01 ). Between 1 year after therapy in the total Qol scores and PF, PR, GH, VT, SF, ER, MH, dimensionality were lower than control groups, there were significant differences(P＜0.05 ). The main factors affecting the Qol of patients with MDR-TB were cultural level, kinds of drug resistant and reduction of counts of white blood cell. Conclusion The correlation between quality of life and education, the number of drug resistance, reduction of white blood cell in patients with multi-drugresistant pulmonary tuberculosis.