58例非结核分枝杆菌的临床分析

发布时间：2018-04-12 19:45

本文选题：分枝杆菌 + 结核　；参考：《重庆医学》2014年07期

【摘要】：目的提高非结核分枝杆菌(NTM)肺病的诊断、鉴别诊断及治疗水平。方法对该院2008年3月至2012年3月住院的58例分枝杆菌培养阳性并鉴定为NTM的患者进行队列研究,将其分为单药物组和联合用药组,每组各29例,经过6~8个月的治疗后,对两组的治愈率进行对比分析。结果 567例分枝杆菌培养检出58例NTM,检出率为10.23%。耐药情况:NTM菌株对常用的异烟肼、链霉素等药物耐药,耐药率分别为100.0%、96.5%,但对卷曲霉素、卡那霉素等有一定敏感性,敏感率为46.6%、44.8%。临床特征:咳嗽、咳痰58例(100.0%),消瘦29例(50.0%),气促26例(35.3%),咯血19例(32.4%),胸膜炎12例(23.5%),乏力9例(17.6%),发热7例(11.8%),盗汗5例(8.8%),痰涂片抗酸杆菌阳性11例(23.5%)。胸部影像学表现大体特点:3个肺野39例(67.6%),其中两侧全肺野15例(29.4%),空洞17例(35.3%)。治疗效果:单药物组治愈率为41.3%,联合用药组治愈率为72.4%。结论 NTM肺病的临床表现与肺结核相似,肺部病灶多肺野,进展缓慢,耐药率高。
[Abstract]:Objective to improve the diagnosis, differential diagnosis and treatment of nontuberculous Mycobacterium tuberculosis (NTM) pulmonary disease.Methods A cohort study was conducted on 58 cases of mycobacterium culture positive and identified as NTM in our hospital from March 2008 to March 2012. The patients were divided into single drug group and combined drug group with 29 cases in each group. After 6 ~ 8 months of treatment, the patients were divided into two groups.The cure rate of the two groups was compared and analyzed.Results 58 cases of NTM were detected in 567 cases of mycobacterium culture, the positive rate was 10.23%.The resistance of strain: NTM to isoniazid and streptomycin was 100.00.96. 5, but it was sensitive to capricorubicin and kanamycin, and the sensitivity rate was 46. 8%.The general features of chest imaging findings were as follows: 39 cases with 67.6 cases with 3 lung fields, 15 cases with bilateral whole lung fields with 29. 4% of them, 17 cases with cavity and 35. 3 cases with cavity.The cure rate was 41.3 in the single drug group and 72.4 in the combined drug group.Conclusion the clinical manifestation of NTM pulmonary disease is similar to that of pulmonary tuberculosis.
【作者单位】：重庆市公共卫生医疗救治中心结核科;
【分类号】：R563;R516

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