非结核性菌根性肺病和肺殖民的比较分析:一个病例对照研究
Shi Chen1, Jingjing Zhong1, Qiwen Yang2
1Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
区分非结核菌肺病 (NTM-LD) 和殖民 (NTM-Col) 是至关重要的. 支气管切除和较低的CD4+T细胞计数可能有助于在临床实践中区分NTM-LD和NTM-Col.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 非结核菌 (NTM) 是机会性病原体,经常导致肺部感染.
- 由于症状重叠,区分NTM肺病 (NTM-LD) 和NTM肺殖民 (NTM-Col) 是一个挑战.
- NTM是无处不在的环境微生物.
研究的目的:
- 确定NTM-LD和NTM-Col之间的关键差异,以改善临床诊断.
- 探索潜在的生物标志物,以区分NTM-LD与NTM-Col.
主要方法:
- 从呼吸器样本中分离出的NTM患者的回顾性分析 (2013-2022年).
- 将患者分为NTM-LD和NTM-Col组进行分类.
- 人口,临床,实验室和成像研究结果的比较,包括外围血液淋巴细胞子集.
主要成果:
- 支气管切除症在NTM-LD组的患病率明显高 (P=0.026).
- 在NTM-LD中,mycobacterium细胞内分离率更高 (P=0.004).
- 在NTM-LD患者中观察到较低的CD4+T细胞计数 (P=0.041).
- 支气管切除 (OR=6.282,P=0.016) 和CD4+T细胞计数 (OR=0.997,P=0.012) 是差异诊断的独立因素.
结论:
- 在这两组中,Mycobacterium avium复合体 (MAC) 是主要的NTM分离物.
- 在NTM-LD.中观察到更高的Mycobacterium细胞内菌的隔离率.
- 支气管切除和减少CD4+T细胞数量的成像发现可能有助于区分NTM-LD和NTM-Col.
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