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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2022年03期

页码:

339-343

栏目:

论著

出版日期:

2022-06-20

文章信息/Info

Title:

Analysis of microbiological and clinical characteristic of non-tuberculous Mycobacteria related pulmonary diseases in Guangzhou

作者:

赖 宁; 庄泽钦; 钟 典

510120 广州,广州医科大学附属第一医院,广州呼吸健康研究院,呼吸疾病国家重点实验室,国家呼吸系统疾病临床医学研究中心

Author(s):

Lai Ning;  Zhuang Zeqin;  Zhong Dian.

The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China

关键词:

非结核分枝杆菌;  肺部疾病;  临床特征;  影像学特征

Keywords:

Non-tuberculous mycobacteria;  Pulmonary diseases;  Clinical characteristic;  Radiological presentation

分类号:

R562

DOI:

10.3877/cma.j.issn.1674-6902.2022.03.011

摘要:

目的 分析广州地区不同非结核分枝杆菌(NTM)与其所致肺病的临床特征。方法 选择2016年1月至2020年12月广州地区的112例NTM肺病患者,分析NTM患者的症状、影像学特征及易感因素。结果 112例NTM肺病患者中,男性年龄>50岁占78.7%(48/61),女性年龄>50岁占84.3%(43/51),NTM感染与患者年龄高度相关(r=0.16,P=0.018)。胞内分枝杆菌80例(71.4%)。男性患者更易出现咳嗽症状(48/61)(χ²=3.27,P=0.03),而女性患者更易出现咯血症状(14/51)(χ²=5.39,P=0.021)。年龄大的患者更易出现咯血(16/91)(r=0.21,P=0.015),而年轻患者更易出现气短症状(10/21)(r=0.17,P=0.023)。 NTM肺部疾病最常见的影像学特征是支气管扩张,占40.2%(45/112),肺部结节占36.6%(41/112),多发空洞38.4%(43/112)。NTM感染最常见的易患因素为MTB,占66.1%(74/112); 其次为支气管扩张占25.0%(28/112),合并COPD占17.9%(20/112)。与女性患者相比,男性患者更易合并COPD(OR=5.23,95%CI 5.20～72.60); 胞内分枝杆菌感染更易合并支气管扩张(OR=0.13,95%CI 0.09～0.86)。结论 广州地区NTM感染最常见的病原体是胞内分枝杆菌。NTM感染与患者年龄相关,最常见的影像学表现是支气管扩张、结节影及多发性空洞。MTB感染及器官移植是NTM感染的高危因素。

Abstract:

Objective To analyze the clinical characteristic relevance between different non-tuberculous mycobacteria(NTM)and NTM related pulmonary diseases(NTM-PD)in Guangzhou. Methods We performed a retrospective analysis of 112 NTM-PD patients in Guangzhou from January 2016 to December 2020, analyzing the symptom, radiological characteristic, and risk factor of all NTM-PD patients. Results In all 112 NTM-PD patients, the age of 78.7%(48/61)male patients and 84.3%(43/51)female patients was over 50. NTM infection was also highly related with the age of patient(r=0.16, P=0.018). 71.4%(80)patients were infected with M.intracellulare in all 112 NTM-PD patients. Male patients(61)were more likely to have cough(48)(χ²=3.27, P=0.03), but female patients(51)were more likely to have hemoptysis(14)(χ²=5.39, P=0.021). The older patients(91)were more likely to have hemoptysis(16)(r=0.21, P=0.015), but the younger patients(21)were more likely to have shortness of breath(10)(r=0.17, P=0.023). The most common radiological presentation of NTM-PD was bronchiectasis 40.2%(45/112), pulmonary nodule 36.6%(41/112), multiple cavities 38.4%(43/112). The most common risk factor of NTM infection was tuberculosis 66.1%(74/112), bronchiectasis 25.0%(28/112), COPD 17.9%(20/112). Compared with female patients, male patients were more likely to have COPD(OR=5.23, 95%CI 5.20～72.60). The patients infected with M. intracellulare were more likely to have bronchiectasis(OR=0.13, 95%CI 0.09～0.86). Conclusion The most common pathogenic NTM species was M.intracellulare in Guangzhou. NTM infection was highly related with the age of patient. The most common radiological presentation of NTM-PD was bronchiectasis, pulmonary nodule, and multiple cavities. Tuberculosis infection and organ transplantation were also high risk factor of NTM infection.

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备注/Memo

备注/Memo:

通信作者: 赖 宁, Email: congratulation2001@163.com

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更新日期/Last Update: 2022-06-20