河南省某结核病专科医院57例非结核分枝杆菌肺病患者临床特征及临床分离株鉴定  

Bacterial species distribution and clinical characteristics of 57 patients with non-tuberculous mycobacterial lung disease in a tuberculosis hospital in Henan province

作　　者：王少华[1] 可春梅 孙国清[1] 孙定勇[1] WANG Shaohua;KE Chunmei;SUN Guoqing;SUN Dingyong(tuberculosis prevention and control institute,henan provincial center for disease control and prevention,zhengzhou,450016 henan,china;zhengzhou sixth people'shospital)

机构地区：[1]河南省疾病预防控制中心结核病预防控制所,河南郑州450016 [2]郑州市第六人民医院

出　　处：《河南预防医学杂志》2022年第12期903-906,共4页Henan Journal of Preventive Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200130);河南省科技攻关项目(192102310136)。

摘　　要：目的了解非结核分枝杆菌肺病(NTM-PD)患者的临床特征及临床分离株菌种分布。方法对2019年河南某结核病专科医院57例NTM-PD患者临床资料进行回顾性分析。结果57例NTM-PD患者中,男性占78.9%(45例),≥50岁占78.9%(45例)。临床分离株中,胞内分枝杆菌占57.9%(33株),其次为脓肿分枝杆菌、堪萨斯分枝杆菌及鸟分枝杆菌,分别占19.3%、10.5%和8.8%。NTM-PD患者的临床症状主要为咳嗽、咳痰、发热、胸闷、气喘、咯血等呼吸道症状;男性和女性患者咳血率分别为4.4%(2/45)和58.3%(7/12),两者差异有统计学意义(χ^(2)=16.837,P<0.001)。患者胸部影像学表现最多的为肺部空洞,占57.9%(33例),其次为肺部结节和淋巴结肿大,分别占29.8%(17例)和14.0%(8例);男性和女性患者肺部空洞率分别为66.7%(30/45)和25.0%(3/12),肺部结节率分别为20.0%(9/45)和66.7%(8/12),差异均有统计学意义(P均<0.05)。患者有既往病史或合并症的患者比例为75.4%(43例),其中30例(52.6%)有既往结核病史,13例(22.8%)合并支气管扩张;男性和女性患者合并支气管扩张率分别为11.1%(5/45)和66.7%(8/12),差异有统计学意义(P<0.001)。结论NTM-PD患者以中老年男性为主;患者临床症状特异性差,类似结核病;有既往病史或合并症的比例较高,对有相关病史及合并症的疑似病例应开展NTM-PD筛查,以指导临床治疗。Objective To investigate the bacterial species distribution and clinical characteristics of 57 patients with non-tuberculous mycobacterial pulmonary disease(NTM-PD)in a tuberculosis hospital of Henan province.Methods The clinical characteristics of 57 patients with NTM-PD in the hospital in 2019 were retrospectively reviewed and analyzed.Results Of the 57 patients with NTM-PD,78.9%(45 patients)were male,and 78.9%(45 patients)were≥50 years old.Most of the infected strains identified were Mycobacterium intracellulare,accounting for 57.9%,followed by Mycobacterium abscessus,Mycobacterium Kansasii and Mycobacterium avium,accounting for 19.3%,10.5%and 8.8%,respectively.The clinical symptoms of NTM-PD patients mainly included cough,expectoration,fever,chest tightness,asthma,hemoptysis and other respiratory symptoms.The proportions of hemoptysis in males and females were 4.4%(2/45)and 58.3%(7/12),respectively,and the difference was statistically significant(χ^(2)=16.837,P<0.001).The most common chest imaging manifestation of NTM-PD patients was pulmonary cavity,accounting for 57.9%,followed by pulmonary nodules and lymphadenectasis,accounting for 29.8%and 14.0%,respectively.The proportions of pulmonary cavity in males and females were 66.7%(30/45)and 25.0%(3/12),respectively,and the proportions of pulmonary nodules in males and females were 20.0%(9/45)and 66.7%(8/12),respectively;the differences were both statistically significant(both P<0.05).The proportion of patients with previous diseases or complications was 75.4%(43 patients),including 30 patients(52.6%)with previous TB history and 13 patients(22.8%)combined with bronchiectasis.The proportions of bronchiectasis in males and females were 11.1%(5/45)and 66.7%(8/12),respectively,and the difference was statistically significant(P<0.001).Conclusion NTM-PD patients are mainly middle-aged and old men.NTM-PD patients have clinical symptoms similar to tuberculosis with poor specificity.NTM-PD patients have a high proportion of previous diseases or complications.NTM lung

关 键 词：非结核分支杆菌 非结核分支杆菌肺病 菌种鉴定 临床特征 

分 类 号：R378.91[医药卫生—病原生物学]