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目的 探讨南方部队结核病的分子流行病学规律。方法 设计一对特异性IS6 110外向性引物 ,应用聚合酶链反应 (PCR)建立检测结核分支杆菌DNA指纹多态性的方法 ,分析结核分支杆菌DNA多态性与流行病学的关系。结果 共检测分析了 15 4株结核分支杆菌DNA的指纹多态性。根据这些菌株的指纹多态性特征共分为 8个类型 ,以Ⅰ型 (36 .4 % )、Ⅱ型 (31.8% )和Ⅲ型(2 1.4 % )为主 ,其余各型均少于 4 %。以 2 0～ 2 9岁和 30～ 39岁组在这三型中所占比例最大 ,分别为31.8%和 2 7.9%。驻城镇部队与驻乡村部队以及结核病患者有无卡介苗接种史 ,在这三型的分布差异无显著统计学意义 (P >0 .0 5 )。但初治与复治患者分离菌株的PCR扩增指纹类型的分布差异有显著统计学意义 (P <0 .0 5 )。所检测菌株是否具有耐药性 ,在这三型中的分布差异也有显著统计学意义 (P <0 .0 5 )。菌株耐药主要为单耐异烟肼和利福平 ,耐药菌株在Ⅰ、Ⅱ、Ⅲ型中所占比例分别是4 4 .4 %、2 9.6 %和 14 .8%。结论 PCR扩增指纹多态性分型技术是一种简便、快速、敏感、特异和重复性好的分型方法 ,可用于结核病的分子流行病学研究。南方部队结核分支杆菌的传播以Ⅰ、Ⅱ、Ⅲ型为主 ,应加强此三型菌株流行的监控。
Objective To investigate the molecular epidemiology of tuberculosis in the southern army. Methods A pair of specific IS6 110 exogenous primers was designed and a polymerase chain reaction (PCR) method was established to detect DNA fingerprinting of Mycobacterium tuberculosis. The relationship between Mycobacterium tuberculosis DNA polymorphism and epidemiology was analyzed. Results A total of 15 4 strains of Mycobacterium tuberculosis DNA fingerprinting were analyzed. According to the fingerprinting polymorphism of these strains, there are eight types of fingerprinting, which are type I (36.4%), type II (31.8%) and type III (21.4%), while the others are less than 4 %. The proportions of these three types were the largest in the groups of 20 to 29 years and 30 to 39 years, accounting for 31.8% and 29.9% respectively. There was no significant difference in the distribution of BCG vaccination between the towns and villages units and the rural units and tuberculosis patients (P> 0.05). However, there were significant differences in the distribution of fingerprints of PCR-amplified strains isolated from patients with newly diagnosed and retreatment (P <0.05). The tested strains are drug-resistant, in the distribution of these three types of differences are also statistically significant (P <0. 05). The strains were resistant to isoniazid and rifampicin, and the resistant strains accounted for 44.4%, 29.6% and 14.8% of the total in type I, II and III, respectively. Conclusion PCR amplification fingerprinting polymorphism is a simple, rapid, sensitive, specific and reproducible typing method, which can be used in the molecular epidemiology of tuberculosis. The southern army of Mycobacterium tuberculosis spread to Ⅰ, Ⅱ, Ⅲ type should be strengthened to monitor the prevalence of these three types of strains.