天津地区106例NTM肺病患者的菌种分布及临床特征分析  

Distribution and clinical feathers of 106 patients with non-tuberculous mycobacteria pulmonary diseases in Tianjin

作　　者：王妍 邵红霞[1,2] 张凯茹 郑兴杰[1,2] 武俊平 于洪志[1,2] WANG Yan;SHAO Hongxia;ZHANG Kairu;ZHENG Xingjie;WU Junping;YU Hongzhi(Department of Tuberculosis,Tianjin Haihe Hospital,Tianjin 300350,China;TCM Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine)

机构地区：[1]天津市海河医院结核科,300350 [2]国家中医药管理局中医药防治传染病重点研究室

出　　处：《天津医药》2023年第6期633-637,共5页Tianjin Medical Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-067C);天津市卫生健康科技项目(TJWJ2022XK035);天津市科技计划项目(22JCYBJC00730)。

摘　　要：目的分析天津地区非结核分枝杆菌(NTM)肺病患者的菌种分布及临床特征,为天津地区NTM肺病临床诊治提供参考。方法选取NTM肺病患者106例,分析NTM菌种分布情况、不同NTM菌种感染患者合并症和临床表现分布、胸部影像学表现;比较感染胞内分枝杆菌、龟脓肿分枝杆菌和堪萨斯分枝杆菌患者白细胞、血红蛋白、血白蛋白水平。结果106例NTM肺病患者,分布在前3位的菌种是胞内分枝杆菌(39.62%,42/106)、堪萨斯分枝杆菌(23.58%,25/106)和龟脓肿分枝杆菌(23.58%,25/106)。患者主要的合并症有肺结核、支气管扩张、慢性阻塞性肺疾病和糖尿病。就诊时临床表现以咳嗽咳痰最为常见(64.15%,68/106),其次为发热(35.85%,38/106),气短喘息(16.98%,18/106)和咯血(16.04%,17/106)等。100例患者的影像学特征表现以渗出、空洞及支气管扩张为主。胞内分枝杆菌感染患者胸腔积液比例高于龟脓肿分枝杆菌和堪萨斯分枝杆菌感染患者(P<0.05);堪萨斯分枝杆菌感染患者支气管扩张比例低于胞内分枝杆菌和龟脓肿分枝杆菌感染患者(P<0.01)。胞内分枝杆菌感染患者血红蛋白水平低于龟脓肿分枝杆菌和堪萨斯分枝杆菌感染患者(P<0.05),白蛋白水平低于龟脓肿分枝杆菌感染患者(P<0.05)。结论天津地区NTM肺病患者流行菌种以胞内、堪萨斯、龟脓肿分枝杆菌为主,临床表现多为咳嗽咳痰、发热等,影像学表现以渗出、空洞及支气管扩张为主。Objective To analyze the strain distribution and clinical characteristics of non-tuberculous Mycobacterium(NTM)lung disease patients in Tianjin area,and to provide reference for clinical diagnosis and treatment of NTM lung disease in Tianjin area.Methods A total of 106 patients with NTM pulmonary disease were selected.The distribution of NTM bacteria,the distribution of complications and clinical manifestations of patients and the chest imaging manifestations with different NTM bacteria infection were analyzed.Levels of leukocyte,hemoglobin and serum albumin in patients infected with Mycobacterium intracellular,Mycobacterium chelonabscessus and Mycobacterium kansasii were compared.Results Among 106 patients with NTM lung disease,the top three strains were Mycobacterium intracellular(39.62%,42/106),Mycobacterium kansasii(23.58%,25/106)and Mycobacterium chelonabscessus(23.58%,25/106).The main complications were pulmonary tuberculosis,bronchiectasis,chronic obstructive pulmonary disease and diabetes.Cough and expectoration were the most common clinical manifestations(64.15%,68/106),followed by fever(35.85%,38/106),shortness of breath(16.98%,18/106)and hemoptysis(16.04%,17/106).The imaging features of 100 patients were mainly exudation,cavity and bronchiectasis.The proportion of pleural effusion in Mycobacterium intracellular infection patients was higher than that in Mycobacterium chelonabscessus infection patients and Mycobacterium kansasii infection patients(P<0.05).The proportion of bronchiectasis was lower in Mycobacterium kansasii infection patients than that in Mycobacterium intracellular infection patients and Mycobacterium chelonabscessus infection patients(P<0.01).The hemoglobin level was lower in patients with mycobacterium intracellular infection than that in patients with Mycobacterium chelonabscessus and Mycobacterium kansasii infection(P<0.05).Albumin level was lower than that in patients with Mycobacterium chelonabscessus infection(P<0.05).Conclusion The prevalent strains of NTM pulmonary disease pati

关 键 词：非结核分枝杆菌 堪萨斯分枝杆菌 脓肿分枝杆菌 非结核分枝杆菌肺病 菌种鉴定 临床特征 

分 类 号：R52[医药卫生—内科学]