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目的 比较基因芯片和比例法药物敏感性试验(简称“药敏试验”)在检测结核分枝杆菌对利福平和异烟肼耐药性中的应用效果.方法 选取2013年9月至2016年12月海南医学院第二附属医院598例涂阳肺结核住院患者的痰标本,具有传统药敏结果和基因芯片结果的484例患者纳入分析.采用基因芯片法检测rpoB、katG及inhA基因耐药突变位点及频率,以比例法药敏试验结果为金标准,比较两种方法的符合率.结果 基因芯片和比例法药敏试验检测结核分枝杆菌对利福平的耐药性符合率为93.8％ (454/484),对异烟肼的耐药性符合率为89.0％(431/484),对耐多药的符合率为95.5％(462/484).118株检测到rpoB基因发生突变,优势突变位点为531,占56.8％(67/118);其次突变位点是526,占19.5％(23/118);516突变位点占12.7％(15/118).97株检测到katG和inhA基因突变,最常见的突变位点是katG315,占82.5％(80/97),inhA均为-15突变类型,占14.4％(14/97).结论 基因芯片法与比例法具有很好的一致性,可成为筛查结核分枝杆菌对利福平和异烟肼是否耐药的快速有效的方法.“,”Objective To compare Genechip and the proportion method drug susceptibility test in detecting Mycobacterium tuberculosis resistance to rifampin and isoniazid.Methods A total of 598 sputum specimens of sputum smear-positive pulmonary tuberculosis inpatient cases from the Affiliated Hospital of Hainan Medical College between September 2013 and December 2016.Finally,484 patients with the results of both traditional drug susceptibility test and Genechip were included.Genechip was used to detect the mutations and frequencies of rpoB,katG and inhA.The proportion method drug susceptibility test was used as the gold standard to evaluate the overall concordance.Results Compared with the proportion method drug susceptibility test,the coincidence rate of Mycobacterium tuberculosis resistance to rifampin and isoniazid detected by Genechip was 93.8％ (454/484) and 89.0％(431/484),respectively,and that to muhi-drug resistance was 95.5％ (462/484).The rpoB mutations were detected in 118 strains,of which 56.8％ (67/118) carried mutations at codon 531,19.5％ (23/118) at codon 526,12.7％ (15/118) at codon 516.Of all the 97 strains with katG and inhA mutations,the predominant mutation site of katG was codon 315 with the mutation rate of 82.5％ (80/97),and 14.4％ (14/97) carried mutations at inhA-15 (C→T).Conclusion The results of Genechip method were highly consistent with that of proportion method drug susceptibility test,and Genechip was a fast and effective method for screening for rifampin and isoniazid against Mycobacterium tuberculosis.