缓慢与快速生长型非结核分枝杆菌肺病的临床特征对比分析

Comparative Analysis of Clinical Characteristics of Slow-growing and Hapidly-growing Non tuberculous Mycobacterial Pulmonary Disease

目的分析缓慢与快速生长型非结核分枝杆菌(NTM)肺病的菌种分布情况及临床特征。方法收集2018年1月至2021年1月期间于我院确诊的341例人类免疫缺陷病毒阴性NTM肺病患者信息,对数据进行整理分析。结果341例NTM肺病患者中,以中老年人多见,最常见的致病菌种为胞内分枝杆菌,其次为龟/脓肿分枝杆菌和鸟分枝杆菌。常见的合并症为支气管扩张,既往结核病史,尘肺。NTM肺病的影像学表现最常见的是肺结节、肺部空洞及淋巴结肿大。缓慢生长型分枝杆菌(SGM)肺病患者中男性占比高,合并尘肺者多;影像学更易表现为空洞;快速生长型分枝杆菌(RGM)肺病患者中既往结核病史及合并有支气管扩张的占比高,临床咳嗽咳痰症状明显。结论NTM肺病好发于中老年,既往有支气管扩张、结核病史及尘肺等合并症,肺部有结节及空洞等影像学表现的患者;男性、既往有尘肺病史、影像学表现为肺部空洞的患者更多见于SGM肺病,既往有支气管扩张及结核病史,临床表现为咳嗽咳痰的患者更多见于RGM肺病。

Objective To analyze the distribution and clinical characteristics of slow and hapidly-growing non tuberculous Mycobacterium(NTM)pulmonary disease.Methods The information of 341 patients with human immunodeficiency virus negative NTM lung disease diagnosed in our hospital from January 2018 to January 2021 was collected and analyzed.Results among 341 patients with NTM lung disease,the middle-aged and elderly were more common.The most common pathogenic bacteria were intracellular Mycobacterium,followed by Turtle/abscess Mycobacterium and bird Mycobacterium.Common complications include bronchiectasis,past history of tuberculosis and pneumoconiosis.The most common imaging manifestations of NTM lung disease are pulmonary nodules,pulmonary cavities and lymphadenopathy.The proportion of men in patients with slow-growing Mycobacterium(SGM)lung disease was high,and there were more patients with pneumoconiosis;Imaging is more likely to be empty;The rapid growth Mycobacterium(RGM)patients with lung disease had a higher history of tuberculosis and bronchiectasis,and cough and cough were obvious.Conclusion NTM lung disease is frequently found in middle-aged and elderly patients.There are previous imaging findings of bronchiectasis,tuberculosis and pneumoconiosis.Men,past pneumoconiosis history,and imaging findings of pulmonary cavity were more common in SGM lung disease,and had history of bronchiectasis and tuberculosis.Cough and expectoration were more common in RGM lung disease.