摘要
目的探讨非结核分枝杆菌肺病的临床特点,提高非结核分枝杆菌肺病的发现、诊断及鉴别诊断水平,减少误诊误治。方法选取北京结核病控制研究所2013年1月至2016年12月确诊的42例非结核分枝杆菌肺病(NTM)患者的病例资料信息进行回顾性分析总结。结果在42例非结核分枝杆菌肺病患者中,确诊胞内分枝杆菌14例;鸟分枝杆菌9例;堪萨斯分枝杆菌6例;偶然分枝杆菌6例;脓肿分枝杆菌5例;龟分枝杆菌2例。42例患者的主要症状有咳嗽、咳痰31例(73.81%),咯血6例(14.29%),发热8例(19.05%)。药敏试验表明研究中的非结核分枝杆菌对常见抗结核药物具有高度耐药性,一线4种药总耐药率高达100%,一线4种药全耐药率高达69.05%,其中脓肿分枝杆菌对参与测试的9种抗结核药物均有较高耐药性。结论由于非结核分枝杆菌肺病发病的隐蔽性及非结核分枝杆菌极强的耐药性,给非结核分枝杆菌肺病的诊治带来了极大困难。因此临床亟待一种更为快捷准确的诊断方法,对非结核分枝杆菌肺病的发现、诊断及治疗具有重要意义。
Objective To investigate the clinical characteristics of non-tuberculosis mycobacteria lung disease,improve the detection,diagnosis and differential diagnosis of non-tuberculosis mycobacteria pulmonary disease,and reduce the misdiagnosis and misdiagnosis. Methods The data of 42 cases of non-tuberculosis mycobacteria lung disease（ NTM） diagnosed in Tianjin Institute of Tuberculosis Control from January 2013 to December 2016 were retrospectively analyzed. Results Of the 42 patients with non-tuberculosis mycobacteria,14 were diagnosed with mycobacterium intracellulare,9 were mycobacterium avium,6 were mycobacterium kaempferi,6were mycobacterium avium,5 were mycobacterium abscess,mycobacterium tritici in 2 cases. 42 patients with the main symptoms of cough,sputum in 31 cases（73. 81%）,hemoptysis in 6 cases（14. 29%）,fever in 8cases（ 19. 05%）. The antimicrobial susceptibility test showed that the non-tuberculosis mycobacterium was highly resistant to common anti-tuberculosis drugs,the total drug resistance rate was 100%,the total resistance rate of the first line 4 drug was as high as 69. 05%,and the mycobacterium abscess 9 drugs involved in the testwere highly resistant to anti-TB drugs. Conclusion Because of the concealment of non-tuberculosis mycobacteria and the strong resistance to non-tuberculosis mycobacteria,it is very difficult for the diagnosis and treatment of nontuberculosis mycobacteria. So it is needed a more rapid and accurate diagnosis method for the non-tuberculosis mycobacteria lung disease discovery,which has great significance in diagnosis and treatment in clinicalpractices.
作者
徐静
杜娈英
罗萍
XU Jing DU Luanying LUO Ping(Beijing Institute of TB Control, Beijing 100035, China Chengde Medical College, Chengde 067000, China)
出处
《医学研究与教育》
CAS
2017年第4期12-16,共5页
Medical Research and Education
关键词
非结核分枝杆菌肺病
耐药性
临床分析
non-tuberculous mycobacterium tuberculosis
drug resistance
clinical analysis
