本文選題：分枝桿菌 + 結核　； 參考：《重慶醫(yī)學》2014年07期

【摘要】：目的提高非結核分枝桿菌(NTM)肺病的診斷、鑒別診斷及治療水平。方法對該院2008年3月至2012年3月住院的58例分枝桿菌培養(yǎng)陽性并鑒定為NTM的患者進行隊列研究,將其分為單藥物組和聯(lián)合用藥組,每組各29例,經(jīng)過6~8個月的治療后,對兩組的治愈率進行對比分析。結果 567例分枝桿菌培養(yǎng)檢出58例NTM,檢出率為10.23%。耐藥情況:NTM菌株對常用的異煙肼、鏈霉素等藥物耐藥,耐藥率分別為100.0%、96.5%,但對卷曲霉素、卡那霉素等有一定敏感性,敏感率為46.6%、44.8%。臨床特征:咳嗽、咳痰58例(100.0%),消瘦29例(50.0%),氣促26例(35.3%),咯血19例(32.4%),胸膜炎12例(23.5%),乏力9例(17.6%),發(fā)熱7例(11.8%),盜汗5例(8.8%),痰涂片抗酸桿菌陽性11例(23.5%)。胸部影像學表現(xiàn)大體特點:3個肺野39例(67.6%),其中兩側全肺野15例(29.4%),空洞17例(35.3%)。治療效果:單藥物組治愈率為41.3%,聯(lián)合用藥組治愈率為72.4%。結論 NTM肺病的臨床表現(xiàn)與肺結核相似,肺部病灶多肺野,進展緩慢,耐藥率高。
[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.
【作者單位】： 重慶市公共衛(wèi)生醫(yī)療救治中心結核科;
【分類號】：R563;R516

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