626例耐药肺结核临床特征及其耐药基因突变分布
Clinical characteristics of 626 cases of drug-resistant pulmonary tuberculosis and mutations of drug resistance genes
方珂 1李丹 2汤中文 3余娇 1程芳4
作者信息
- 1. 武汉市金银潭医院手术室,湖北武汉 430000
- 2. 武汉市金银潭医院麻醉科,湖北武汉 430000
- 3. 武汉市金银潭医院结核外科,湖北武汉 430000
- 4. 武汉市金银潭医院护理部,湖北武汉 430000
- 折叠
摘要
目的 分析626例耐药肺结核患者的临床特征及其耐药基因突变特征.方法 纳入2018年6月—2022年12月武汉市金银潭医院收治的肺结核患者626例进行研究,根据其结核分枝杆菌耐药情况,分别纳入耐药组(189例)、非耐药组(437例).分析肺结核患者耐药情况,分析肺结核患者耐药临床特征,分析肺结核患者耐药基因突变特征.结果 626例肺结核患者分离626株结核分枝杆菌,其中耐药189例,耐药率为30.19％,耐多药87例,异烟肼、链霉素、利福平耐药率较高;临床特征分析结果显示,耐药组年龄、病历类型复治高于非耐药组(P＜0.05);肺结核患者耐药基因突变主要为katG基因突变(315位Ser替代为Thr,突变率为38.10％),rpoB基因突变(521位Ser替代为Leu,突变率为28.04％),rpsL基因突变(43位Lys替代为Arg,突变率为26.98％).结论 肺结核患者耐药情况不容乐观,耐药临床特征包括年龄≥60岁、病历类型复治等,分析其临床特征及耐药基因突变特征,可为预防措施的制定提供依据.
Abstract
OBJECTIVE To analyze the clinical characteristics and mutation of drug-resistant genes in 626 patients with pulmonary tuberculosis.METHODS A total of 626 patients with tuberculosis admitted to Jinyintan Hospital in Wuhan from Jun 2018 to Dec 2022 were included in the study.According to the drug resistance of Mycobacteri-um tuberculosis,the patients were divided into the drug-resistant group(189 cases)and non-drug-resistant group(437 cases).The status of drug resistance,clinical characteristics and the mutation characteristics of drug-resist-ant genes in patients with tuberculosis were analyzed.RESULTS 626 strains of M.tuberculosis were isolated from 626 patients with pulmonary tuberculosis,of which 189 were drug-resistant,with the drug-resistant rate of 30.19％,and 87 were multidrug resistant.Clinical characteristics analysis showed that the age and the rate of re-treatment in the drug-resistant group and the type of retreatment were higher than those in the non-drug-resistant group(P＜0.05).The main mutation of drug resistance genes in tuberculosis patients were katG gene mutation(315 Ser replaced by Thr,mutation rate 38.10％),rpoB gene mutation(521 Ser replaced by Leu,mutation rate 28.04％),and rpsL gene mutation(43 Lys replaced by Arg,mutation rate 26.98％).CONCLUSION The drug re-sistance of M.tuberculosis in tuberculosis patients is not optimistic.The clinical characteristics of drug resistance include age ≥60 years old and retreatment of medical history type.Analysis of the clinical characteristics and mu-tation characteristics of drug resistance genes could provide a basis for the formulation of preventive measures.
关键词
肺结核/耐药/结核分枝杆菌/基因突变/临床特征Key words
Pulmonary tuberculosis/Drug resistance/Mycobacterium tuberculosis/Gene mutation/Clinical char-acteristics引用本文复制引用
基金项目
湖北省科研项目(2021FH024010)
出版年
2024
NETL
NSTL
万方数据