124例耐多药结核分枝杆菌基因突变特征分析.doc

124例耐多药结核分枝杆菌基因突变特征分析 梁亚萍1 赵丽丽2 高漫1 摘要：目的 对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法 对124例耐多药结核分枝杆菌和50株敏感株的耐药相关基因（异烟肼inhA、 katG和oxyR-ahpC间隔区;利福平rpoB ）进行序列测定，分析其基因突变情况。结果 异烟肼耐药inhA基因突变率为14.5%；katG基因突变率为70.2%（87/124），主要位于315位；oxyR-ahpC间隔区突变率为15.3% ；inhA、 katG两种基因同时突变率75.0%，三种基因同时考虑突变率89.5%。利福平rpoB 基因突变的检出率高达95.2%，突变主要发生在531、526、516位点。 结论 我省耐多药菌异烟肼耐药相关基因最常见突变为katG 315、inhA C-T（-15）、axyR-ahpC间隔区(-10) C-T，利福平为rpoB531、526、516。结合MDR-TB耐药相关基因的特征分析，可以建立一种快速、准确、特异的适合于我省的检测结核耐多药性的新方法。 关键词：结核分枝杆菌 耐多药 基因测序 突变 Analysis of characteristics of genetic mutation of 124 cases of multidrug-resistant mycobacterium tuberculosis Liang Yaping11 Zhao Lili2 Gao Man1 [Abstract]Objective: To analyze the mutation characteristics of multidrug-resistant mycobacterium tuberculosis related genes.Method:Resistant genes of 124 cases of multidrug-resistant mycobacterium tuberculosis and 50 sensitive strains (inhA,katG and oxyR-ahpC spacer of isoniazid;rpoB of rifampicin)were given sequence determination to analyze the gene mutation.Results:Gene mutation rate of inhA was 14.5%; gene mutation rate of KatG was 70.2% (87/124),mainly in the 315;gene mutation rate of oxyR-ahpC spacer was 15.3%;mutation rate of inhA, katG at the same time was 75.0%,mutation rate of the three genes at the same time was 89.5%.Gene mutation rate of rpoB of rifampicin was 95.2%,and mutation occurred mainly in the 531,526,516 sites.Conclusion:The most common mutation of multidrug-resistant isoniazid genes in our province were katG 315, inhA C-T (-15),oxyR-ahpC spacer (-10) C-T,and the rifampicin were rpoB531,526,516.The analysis of combining the feature of MDR-TB resistance related gene can establish a rapid, accurate, specific and suitable new method to detect multidrug-resistant tuberculosis. Key words: Mycobacterium tuberculosis ;Multidrug-resistant;Gene sequencing;Mutation 【中图分类号】：R52 【文献标识码】： 【文章编号】： 我国的耐药结核病流行情况较为严重，是全球27个耐药结核高负担国家之一，据全国结核病耐药基线调查结果显示[1]：我国肺结核病患者中耐多药结核（MDR-TB，指结核分枝杆菌同时对异烟肼、利福平耐药）耐药率为8.32%。我省是结核病