63例非结核分枝杆菌肺病的流行病学及临床特点分析

Analysis on Epidemiological and Clinical Characteristics of 63 Cases of Nontuberculous mycobacterial(NTM) Lung Disease

目的探讨非结核分枝杆菌肺病的临床特点及防治对策。方法对2009-2011年7月广州市结核病防治所二分所经过实验室检查确诊的63例非结核分枝杆菌肺病患者进行分析。结果非结核分枝杆菌肺病波及两肺叶为多(58%),双侧同时患病较多(51%),空洞仅占25%。涂阴培阳44%,涂阳培阳56%,菌型鉴定以龟分枝杆菌为多占44%。耐药以耐多药比例最大(占77%),耐药顺位为耐多药>耐二药>单药。仅有3例是对一二线抗结核药全敏感。其中47例为初治病例(75%),16例复治病例(25%)。结论由于生活环境的变迁可能导致了非结核分枝杆菌的习性发生了变化,以至于目前非结核分枝杆菌肺病的临床特点也发生了不同程度的改变。

Objective To investigate the nontuberculous mycobacterial（NTM） lung disease prevention and treatment of clinical features and treatment response. Methods Sixty-three cases of nontuberculous mycobacterial lung disease confirmed by the laboratory testing in the Second Clinic of Guangzhou Tuberculosis Dispensary from 2009 to July 2011 were analyzed. Results The case of both lung lobe were affected by nontuberculous mycobacterial accounted for 58%,while the case of both sides of lung were affected accounted for 51%,and the cavityaccounted for only 25%.The bacteria-based identification of M.chelonei accounted for more than 44% for the.Multiple drug resistance tuberculosis accounted for the largest proportion（77%） of drug-resistance. Conclusions As the environment changes may result in a nontuberculous mycobacteria habits change,so the current nontuberculous mycobacterial lung disease also occurred in the clinical features of varying degrees of change.In order to have a better control of multidrug-resistant tuberculosis,MDR-TB,and prevent the spread and infection of both multiple drug resistance tubercle bacillus and NTM with the property of MDR,therefore nontuberculous mycobacterial lung disease cannot be ignored.