The Value Research Of Drug-resistant Tuberculosis Screening And Serum Detection Of Tuberculosis Antibodies

Objective: To investigate the drug resistance of Mycobacterium tuberculosis and the clinical application value of the detection results of serum TB antibody.Methods: 294 TB patients were selected as the study object.143 TB drug-resistant group and 151 TB sensitive group were screened by INH,RFP,Sm,EMB,OFX,CPM,Km and Pto.150 non TB patients in the same period were selected as the control group.38 KDa antibody,16 KDa antibody and LAM antibody were detected by Tuberculosis Protein Chip in drug resistant group,sensitive group and control group respectively.The results were statistically analyzed by spss19.0.Results: INH(73.42%)had the highest drug resistance rate,while RFP(69.96%),Sm(41.95%),OFX(37.76%),EMB(20.27%),Km(5.59%)and CPM(2.79%),no Pto resistance.There was no Pto resistance.The drug-resistant group of tuberculosis included five main drug-resistant types,The incidence of MDR-TB was 51.7%,MR-TB was 27.8%,PDR-TB was 11.9%,OFX resistant-TB was 9.1% and XDR-TB was 3.5%,but no resistance to CPM,Km and Pto was found.There are five types of PDR-TB,four types of MDR-TB,three types of MR-TB and three types of XDR-TB.There are six positive patterns in the detection of serum TB antibody.The most common pattern is 38KDa(+)+ 16 k Da(-)+ Lam(+).Compared with the control group,the positive rate of TB antibody in 294 TB patients was statistically significant(?2 = 261.33,P<0.01).The positive rate of TB antibody in TB drug resistant group was 85.31%,significantly higher than that in TB sensitive group 77.48%,but the difference was not statistically significant(?2 = 2.10,P>0.05).The highest positive rate of TB antibody was 91.89% in MDR-TB,88.23% in PR-TB,82.35% in MR-TB,80.0% in XDR-TB and 53.84% in OFX resistant-TB.There were 96 cases of PR-TB,MDR-TB and XDR-TB.The positive rate of serum TB antibody in “multi-drug resistant tuberculosis” was 90.62%(87 / 96),which was significantly higher than that in TB sensitive group(77.48%)(2 = 6.59,P < 0.05).Conclusion: Among the first-line antituberculosis drugs,INH resistance rate was the highest,while the second-line antituberculosis drug OFX resistance rate was the highest.There are 16 types of drug-resistant tuberculosis,among which "INH + RFP" is the most common,and the types of drug-resistant tuberculosis are various and complex,which puts forward higher requirements for clinical treatment,especially for MDR-TB.No single resistant strains of CPM,Km and Pto have been found,indicating that CPM,Km and Pto have good sensitivity to Mycobacterium tuberculosis;The positive result of TB antibody test in TB patients is "38k Da(+)+16k Da(-)+LAM(+)";The positive rate of serum TB antibody was the highest in MDR-TB and the lowest in drug-resistant OFX resistance-TB;the positive rate of serum TB antibody in “multi-drug resistant tuberculosis” was 90.62% higher than that in TB sensitive group(77.48%),which indicated that the positive result of serum TB antibody could have certain clinical value for the determination of“multi-drug resistant tuberculosis”.