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目的 :了解军人肺结核病人结核分枝杆菌耐药情况及评价耐药基因检测的应用价值。方法 ;采用聚合酶链反应 单链构象多态性分析 (PCR SSCP)检测结核分枝杆菌rpoB、katG、rpsL、pncA和embB基因突变 ,用绝对浓度法作药物敏感试验 ,采用耐药基因检测等方法 ,对我院 1995年 1月～ 2 0 0 2年 6月痰结核杆菌培养阳性的肺结核菌种进行鉴定、检测其耐药性 ,并与地方肺结核病人进行比较。结果 ;军人组和非军人组初治耐药率分别为 31 5 %和 4 0 8%复治耐药率分别为 78 5 %和 76 2 %。复治耐药率均明显高于初治耐药率 (P <0 0 5 )。军人组耐药频度从高到低依次为异烟肼、利福平、链霉素、吡嗪酰胺和乙胺丁醇 ,非军人组为利福平、异烟肼、链霉素、吡嗪酰胺和乙胺丁醇。用药 >6个月者耐药率为 6 9 0 % ,显著高于其他各组 (P <0 0 1)。药敏试验阳性株的耐药基因检测阳性率为 33 9%～ 85 9% ,耐药基因检测阳性株的药敏试验阳性率为 92 0 %～ 10 0 %。结论 :军人结核病人耐药情况与地方病人相类似 ,应重视军人肺结核病人耐药性监测 ,耐药基因检测有潜在的应用价值
Objective: To understand the drug resistance of Mycobacterium tuberculosis in military patients with tuberculosis and to evaluate the value of drug resistance testing. Methods The mutations of rpoB, katG, rpsL, pncA and embB in Mycobacterium tuberculosis were detected by polymerase chain reaction single strand conformation polymorphism (PCR SSCP). The absolute concentration method was used for drug susceptibility testing and drug resistance gene test Methods: Our hospital from January 1995 to June 2002 sputum Mycobacterium tuberculosis culture positive tuberculosis species were identified, tested for drug resistance, and compared with the local tuberculosis patients. Results: The initial drug-resistant rates in the military and non-military groups were 31.5% and 40.8%, respectively, with rates of retreatment of 78.5% and 76.2%, respectively. The rate of retreatment was significantly higher than the rate of initial cure (P <0 05). In the military group, the frequency of resistance was isoniazid, rifampicin, streptomycin, pyrazinamide and ethambutol from high to low, and rifampicin, isoniazid, streptomycin and streptomycin Azinamide and Ethambutol. Drug resistance rate of 6 months was 6 9 0%, significantly higher than other groups (P 0 01). The positive rate of drug-resistant genes in positive drug susceptibility test was 33 9% -85 9%, and the positive rate of drug susceptibility test positive in drug-resistant gene test ranged from 92 0% to 100%. Conclusion: The resistance of military TB patients is similar to that of local patients, and the monitoring of drug resistance of military TB patients should be emphasized, and the detection of drug resistance genes has potential application value