非结核分枝杆菌感染者肝肾功能、免疫功能和耐药性分析

Liver,Kidney and Immunologic Function and Drug Resistance in Patients with Nontuberculous Mycobacteria Infection

目的分析非结核分枝杆菌感染者肝肾功能、免疫功能及耐药情况与结核分枝杆菌感染者和健康者的差异。方法选取2021年5月至2022年3月在昆明市第三人民医院确诊为非结核分枝杆菌感染者122例和结核分枝杆菌感染者130例,分别设为非结核组和结核组,另选同期健康体检者150例为健康对照组。分析3组性别、年龄、肝肾功能指标、外周血T淋巴细胞亚群和药敏实验结果。结果非结核组、结核组和健康对照组在不同年龄和性别间差异无统计学意义(P>0.05)。非结核组的TBIL、ALT、AST、GGT、CR、UA与结核组和健康组相比均较高(P<0.05)。非结核组的TBIL、ALT、AST和GGT高于结核组(P<0.05)。非结核组和结核组的CD3^(+)T、CD4^(+)T、CD8^(+)T淋巴细胞计数与健康组相比均较低(P<0.05)。非结核组CD8^(+)T淋巴细胞计数高于结核组(P<0.05)。非结核组前3位耐药分别是亚胺/西司、多西环素和米诺环素,耐药率分别为99.18%,78.69%和72.95%;结核组前3位耐药分别是异烟肼、利福平和利福喷丁,耐药率分别为22.32%、17.69%和16.15%。结论非结核分枝杆菌感染者与结核分枝杆菌感染者相比肝功能损伤更为严重,免疫功能易出现紊乱和受损。非结核分枝杆菌对抗生素的耐药种类更多,耐药性更强,临床应加强非结核分枝杆菌和结核分枝杆菌感染的鉴别并合理使用用药方案。

Objective To analyze the differences in liver and kidney function,immune function,and drug resistance between nontuberculous mycobacteria-infected people and healthy people.Methods We collected 122 cases of Nontuberculous Mycobacterium infected people and 130 cases of Mycobacterium tuberculosis-infected people in The Third People’s Hospital of Kunming from May 2021 to March 2022,which were divided into non-Mycobacterium tuberculosis group and tuberculosis group respectively.And 150 cases of healthy people in the same period were selected as a healthy control group.We analyzed the difference in sex,age,liver and kidney function,peripheral blood T lymphocyte subsets and drug sensitivity tests between three groups.Results There was no significant difference between the non-tuberculosis group,tuberculosis group,and healthy group in different ages and sexes(P>0.05).The TBIL,ALT,AST,GGT,CR and UA of the non-tuberculosis group were significantly higher than those in the tuberculosis group and healthy group(P<0.05).TBIL,ALT,AST and GGT in the nontuberculosis group were significantly higher than those in the tuberculosis group(P<0.05).The CD3^(+)T,CD4^(+)T and CD8^(+)T lymphocyte count in the non-tuberculosis group and tuberculosis group were significantly lower than those in the healthy group(P<0.05).The CD8^(+)T lymphocyte count in the non-tuberculosis group was significantly higher than that in the tuberculosis group(P<0.05).The top three drug-resistance medicines in the non-tuberculosis group were imine/doxycycline,doxycycline and minocycline,and the drug resistance rates were 99.18%,78.69%and 72.95%respectively.The top three drug resistance medicine in the tuberculosis group were isoniazid,rifampicin,and rifapentine,and the drug resistance rates were 22.32%,17.69%and 16.15%respectively.Conclusion Compared with Mycobacterium tuberculosis,a non-Mycobacterium tuberculosis-infected person has more serious liver function damage,and the immune function is prone to disorder and damage.Non-tuberculous mycobacteria are more resistant to antibiotics,and the drug resistance is stronger.We should strengthen the identification of nontuberculous mycobacteria and mycobacterium tuberculosis infection in a clinic and use the drug regimen reasonably.