石家庄地区结核分枝杆菌临床分离株基因分型及耐药性分析

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1、授予单位代码10089学号或申请号13685i可於(E搿大交HebeiMedicalUniversity在职科学学位石家庄地区结核分枝杆菌临床分离株基因分型及耐药性分析学位申请人：张志导师：金玉怀教授戴二黑教授专业：病原生物学二级学院：基础医学院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研宄所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料、原

2、始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法r‘研究生签名：导师签章二级学院领导盖章::年月曰河北医科大学研宄生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研宄成果，指导教师对此进行了审定。本论文由本人独立撰写，导师签章年月曰目录中文摘要·············································································1英文摘要················

3、·····························································4英文缩写·············································································7研究论文石家庄地区结核分枝杆菌临床分离株基因分型及耐药性分析前言·············································································9材料与方法················

4、····················································10结果·············································································18附图·············································································24附表·························································

5、····················28讨论·············································································42结论·············································································45参考文献·······································································46综述结核分枝杆菌基因分型技术

6、研究进展……………………………51致谢···················································································56个人简历·············································································57中文摘要石家庄地区结核分枝杆菌临床分离株基因分型及耐药性分析摘要目的：对石家庄地区结核分枝杆菌临床分离株进行基因分型研究和药物敏感性试验,分析了石家庄地区结核分枝杆菌基因多态性

7、和分子流行病学特征，及石家庄地区结核分枝杆菌临床分离株的耐药情况以及耐药菌株基因分型特征,有助于对石家庄地区结核病的流行发展趋势的充分了解，为结核病的有效防治提供科学依据。方法：收集2014年1月至2014年10月期间在石家庄市第五医院就诊的结核病患者经临床分离培养得到的结核分枝杆菌菌株及相应病例背景资料，采用PNB／TCH初步鉴别法和多位点PCR（Multi-locusPCR）进行菌种鉴定。采用比例法进行一线抗结核药（链霉素、异烟肼、利福平、乙胺丁醇）的药物敏感性试验。应用间隔区寡核苷酸基因分型（Spoligotyping）和15位点数目可变

8、串联重复序列分析（VNTR）进行菌株的基因分型。运用BioNumerics5.0软件进行聚类分析，运用SPSS16.0软件进行Hunter-Gasto