摘要
目的:探讨非结核分枝杆菌(NTM)肺病的临床特点。方法:选取2018年9月-2020年8月临床资料完整的60例NTM肺病患者作为研究对象,系统探讨NTM肺病的临床症状、合并症等临床特点,并进行菌种分析及药敏分析,以期为后续抗结核治疗提供理论基础。结果:(1)根据非结核分枝杆菌Runyon分类法,在60例非结核分枝杆菌(NTM)肺病患者中,胞内分枝杆菌32例(53.3%),龟菌脓肿亚种16例(26.7%),堪萨斯分枝杆菌3例(5%),戈登分枝杆菌2例(3.3%),鸟分枝杆菌、草分枝杆菌、偶发分枝杆菌及猪分枝杆菌各1例(1.7%),其中包括有3例(5.0%)患者同时感染2种非结核分枝杆菌,剩余6例(10.0%)尚不明确, (2)从非结核分枝杆菌(NTM)肺病的临床症状分析,主要症状依次为咳嗽(83.3%)、咳痰(75.0%)、咯血(41.7%)及发热(16.7%)。并且常合并支气管扩张(55.0%)、慢性阻塞性肺疾病(15.0%)、肺结核(11.7%)及尘肺病(3.3%)等并发症, (3)药敏分析显示,非结核分枝杆菌对抗结核药物呈现较高的耐药性,对异烟肼耐药率可高达90.7%(49/54),对利福平及阿米卡星的耐药率为57.4%(31/54)及61.1%(33/54),对克拉霉素及莫西沙星的耐药率相对较低,分别为31.5%(17/54)及40.7%(22/54)。结论:NTM肺病临床症状复杂,常合并多种并发症,耐药率较高,需结合多种药物的药敏实验进行指导用药。
Objective:To investigate the clinical features of non-tuberculous mycobacterium(NTM)lung disease.Method:From September 2018 to August 2020,60 cases of NTM pulmonary disease with complete clinical data were selected as the research object,clinical symptoms,complications and other clinical features of NTM pulmonary disease were explored,and the strain and susceptibility were analyzed,so as to provide theoretical basis for the subsequent anti-tuberculosis treatment.Result:(1)According to the classification of non-tuberculosis mycobacteria Runyon in 60 cases of NTM pulmonary disease patients,intracellular mycobacteria infection 32 cases(53.3%),fungus infection turtle abscess subspecies in 16 cases(26.7%),Kansas mycobacterial infection 3 cases(5.0%),Gordon mycobacterial infection in 2 cases(3.3%),bird mycobacteria,grass mycobacteria,occasional mycobacteria and pig mycobacteria in 1 case(1.7%)respectively,including 3 patients(5.0%)at the same time two of mycobacterium tuberculosis infection,and the remaining 6 cases(10.0%)was not clear.(2)From the analysis of clinical symptoms of NTM lung disease,the main symptoms were cough(83.3%),expectoration(75.0%),hemoptysis(41.7%)and fever(16.7%).Bronchiectasis(55.0%),chronic obstructive pulmonary disease(15.0%),pulmonary tuberculosis(11.7%)and pneumoconiosis(3.3%)were common complications.(3)Susceptibility analysis showed that the mycobacterium tuberculosis present higher resistance to anti-tb drugs,of Isoniazid resistance could be as high as 90.7%(49/54),of Rifampicin and Amikacin resistant rate was 57.4%(31/54)and 61.1%(33/54),of Clarithromycin and Moxifloxacin with low percentages,were 31.5%(17/54)and 40.7%(22/54).Conclusion:The clinical symptoms of NTM lung disease are complex,often associated with a variety of complications,and the drug resistance rate is high.Therefore,the drug use should be guided by the drug sensitivity test of a variety of drugs.
作者
陈汉钦
杨俊鹰
许光辉
CHEN Hanqin;YANG Junying;XU Guanghui(Jiangmen Tuberculosis Prevention and Control Institute,Jiangmen 529000,China;不详)
出处
《中外医学研究》
2021年第20期139-141,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
非结核分枝杆菌
肺病
菌种分析
药敏分析
Runyon分类法
临床症状
合并症
Non-tuberculous mycobacterium
Lung disease
Strain analysis
Drug sensitivity analysis
Runyon taxonomy
Clinical symptoms
Complications
