疑似支气管扩张的非结核分枝杆菌病10例临床分析

Clinical analysis of 10 cases of pulmonary nontuberculosis mycobacterium

目的:分析极易与支气管扩张相混淆的非结核分枝杆菌病的临床特征,寻求两者鉴别诊断的依据。方法:对1998年6月至2004年3月间收治的10例肺泡灌洗诊断的非结核分枝杆菌病的患者进行回顾性分析。结果:非结核分枝杆菌病的病史、临床表现、胸片与支气管扩张没有明显的特征性区别。10例患者肺泡灌洗液涂片抗酸菌染色均为阳性,改良罗氏培养基培养:Ⅰ型堪萨斯分枝杆菌2例,偶发分枝杆菌1例,鸟复合分枝杆菌7例。痰普通细菌培养:绿脓杆菌2例,分枝杆菌30例次仅2例次阳性(2/30)。结论:支气管扩张与非结核分枝杆菌病鉴别诊断极为困难,病灶部位高分辨CT可提供诊断线索,支气管镜检查所提供的细菌学结果有鉴别诊断意义。

Objective To differentiate the clinical characteristics of pulmonary nontuberculosis mycobacterium from bronchiectasis. Methods 10 cases of pulmonary nontuberculosis mycobacteria patients from June 1998 to March 2004 were retrospectively analyzed. Results No distinctive difference of history, clinical situation and breast-X-irradiation befween the two deseases. Bronchoalveolar lavage fluid of each patient showed positive results by fast anti-acld staining method （100%）. 2 of 10 patients were found to have Mycobacterium kansasii infection, 1 Mycobacterium fortuitum infection and 7 Mycobacterium avium-intracellulare complex infection. Conclusion It is very difficult to differentiate pulmonary nontuberculosis mycobacterium from bronchiectasis. High solution CT can be helpful to diagnosis at focal lesion. Bacteriology results assisted by bronchial alveolar lavage have an imoortance of differential diagnosis.