摘要
目的研究鸟分枝杆菌复合群(Mycobacterium avium complex,MAC)菌株感染患者的临床特征,为MAC感染所致的肺部疾病防治提供支持。方法收集2016―2023年浙江省东阳市人民医院MAC感染患者的临床信息,基于性别和年龄采用倾向性评分匹配进行匹配(1∶1),以最终是否患病为结局变量构建条件logistic回归分析模型,研究肺部疾病发生的相关因素。结果东阳市MAC优势菌株为副胞内分枝杆菌、胞内分枝杆菌、哥伦比亚分枝杆菌和鸟分枝杆菌。单因素分析结果显示,支气管扩张、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、肿瘤、白细胞计数、血小板计数、中性粒细胞计数、嗜碱性粒细胞计数、红细胞沉降率、C反应蛋白(C-reactive protein,CRP)、D-二聚体、高密度脂蛋白和载脂蛋白B在两组间的差异均有统计学意义(均P<0.05)。进一步logistic条件回归分析结果显示,支气管扩张(OR=1.97,95%CI:1.04~3.71)、COPD(OR=1.30,95%CI:1.15~1.60)、血小板计数(OR=1.01,95%CI:1.01~1.01)、CRP(OR=0.98,95%CI:0.97~0.99)和载脂蛋白B(OR=0.19,95%CI:0.04~0.87)与MAC肺部疾病发生有关(均P<0.05)。结论本研究利用基因序列对比的方法鉴定了东阳市MAC的优势菌群,同时发现该地区伴有支气管扩张或COPD的MAC感染患者是肺部疾病发生的高风险人群;在临床治疗中,还需关注入院期间血小板计数和载脂蛋白B等指标上的升降变化。
Objective This study aimed to investigate the clinical characteristics and laboratory profiles of patients infected with Mycobacterium avium complex(MAC),with the goal of informing improved strategies for the prevention and treatment of MAC-associated pulmonary disease.Methods Clinical data of patients with MAC infections at Dongyang People's Hospital,Zhejiang Province,between 2016 and 2023 were collected.Propensity score matching was applied in a 1:1 ratio based on gender and age.A conditional logistic regression model was constructed with the final disease status as the outcome variable to identify factors associated with the development of lung disease.Results The predominant MAC species in the Dongyang area were Mycobacterium intracellulare,Mycobacterium avium,Mycobacterium chelonae,and Mycobacterium avium.Univariate analysis revealed significant differences between the two groups in bronchiectasis,chronic obstructive pulmonary disease(COPD),tumor,white blood cell count,platelet count,neutrophil count,basophil count,erythrocyte sedimentation rate,C-reactive protein(CRP),D-dimer,high-density lipoprotein,and apolipoprotein B(all P<O.05).Further conditional logistic regression analysis identified bronchiectasis(OR=1.97,95%CI:1.043.71),COPD(OR=1.30,95%CI:1.15-1.60),platelet count(OR=1.01,95%CI:1.01-1.01),CRP(OR=0.98,95%CI:0.97-0.99),and apolipoprotein B(OR=0.19,95%CI:0.04-0.87)as factors associated with the occurrence of MAC lung disease(all P<0.O5).Conclusions This study characterized the predominant MAC species in Dongyang,through genetic sequencing analysis.The findings indicated that MAC-infected patients with concurrent bronchiectasis or COPD faced elevated risks of pulmonary complications.Clinical management should monitor hospitalization indicators including platelet count and apolipoprotein B levels.
作者
赵丹妮
沈鑫黎
潘新灵
赵津
卢斌
田婕
杨敏艺
张素熠
王伟炳
ZHAO Danni;SHEN Xinli;PAN Xinling;ZHAO Jin;LU Bin;TIAN Jie;YANG Minyi;ZHANG Suyi;WANG Weibing(Shanghai Institute of Infectious Disease and Biosecurity,Fudan University,Shanghai 200032,China;Department of Epidemiology,School of Public Health,Fudan University,Key Laboratory of Public Health Safety,Ministry of Education,Fudan University,Shanghai 200032,China;Biomedical Laboratory,Dongyang People's Hospital,Dongyang 322100,China)
出处
《中华疾病控制杂志》
北大核心
2026年第3期303-309,共7页
Chinese Journal of Disease Control & Prevention
基金
上海市市级科技重大专项(ZD2021CY001)
上海市第六轮三年行动计划重点学科项目(GWVI-11.1-03)
金华市科技局重点项目(2022-3-013,2022-3-011)。
关键词
鸟分枝杆菌复合群
非结核分枝杆菌
肺部疾病
倾向性评分匹配
Mycobacterium avium complex
Nontuberculous Mycobacterial
Pulmonary disease
Propensity score matching
