非结核分枝杆菌肺病需要更多关注

Non-tuberculous mycobacterial pulmonary disease requires more attention

非结核分枝杆菌肺病(NTM-PD)是最常见的非结核分枝杆菌感染性疾病,但误诊率高。近年来的研究报道显示,NTM-PD发病率和患病率都呈现逐渐上升趋势。NTM-PD症状和体征无特异性。CT检查主要表现肺部支气管扩张、结节、空洞和实变,常常多种CT表现形式同时存在。由于非结核分枝杆菌在自然界中普遍存在,易污染标本和定植在人呼吸道,单次呼吸道标本分离非结核分枝杆菌阳性不能作为确诊NTM-PD的依据。目前,NTM-PD诊断标准仍采用2007年美国胸科学会/美国感染性疾病学会发布的指南性文件,即呼吸道症状、肺CT表现和微生物学检查三项条件符合诊断要求。该文对NTM-PD的研究进展进行综述。

Non-tuberculous mycobacterial pulmonary disease(NTM-PD)is the most common infectious disease of non-tuberculous mycobacteria,but the misdiagnosis rate is high.In recent years,studies reveal that both the incidence and the prevalence of NTM-PD show a gradual upward trend.The symptoms and signs of NTM-PD are not specific.The main computed tomography(CT)findings are bronchiectasis,nodules,cavities and consolidations in the lungs,often with multiple CT manifestations.Since non-tuberculous mycobacteria are ubiquitous in nature and are prone to contaminating specimens and colonizing in human respiratory tract,a single positive isolation of non-tuberculous mycobacteria from a respiratory tract specimen can not be used as the evidence to confirm the diagnosis of NTM-PD.At present,the diagnostic criteria for NTM-PD still follow the American Thoracic Society(ATS)/Infectious Diseases Society of America(IDSA)statement of diagnosis,treatment,and prevention of NTM diseases issued by the ATS and the IDSA in 2007.The diagnostic criteria require respiratory symptoms,lung CT findings and microbiological examination to meet the diagnostic requirements.In this paper,we review the research progress of NTM-PD.