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Mycobacterium avium复杂肺病患者治疗失败的长期临床过程
Sungmin Zo1, Junsu Choe2, Dae Hun Kim2
1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Antimicrobial agents and chemotherapy
|October 29, 2024
概括
大约一半的耐火性Mycobacterium avium复杂性肺病 (MAC-PD) 患者在停止服用抗生素后需要重新治疗. 肺部破坏和炎症预测在这些具有挑战性的MAC-PD病例中需要进一步治疗.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 尽管有指导方针,但Mycobacterium avium复杂肺病 (MAC-PD) 带来了治疗挑战,一些患者经历了治疗失败.
- 耐药性MAC-PD病例需要仔细管理和了解治疗停止后的长期结果.
研究的目的:
- 在停止治疗后分析治疗不耐药的MAC-PD患者的临床过程.
- 在这个患者队列中确定与需要重新治疗相关的因素.
主要方法:
- 在至少12个月后停止服用抗生素的271名治疗不耐药MAC-PD患者的回顾性分析.
- 根据随后的抗生素需求,患者被分为重新治疗或稳定组.
- 多变量分析确定了重新治疗的预测因素.
主要成果:
- 在271名患者中,138名 (51%) 需要重新治疗,而133名 (49%) 病情保持稳定.
- 与重新治疗相关的因素包括红细胞沉积率升高 (aHR=1.01),肺腔存在 (aHR=1.75),以及受到支气管切除症影响的叶片数量增加 (aHR=1.21).
结论:
- 近50%的耐药性MAC-PD患者停止服用抗生素,最终需要重新治疗.
- 肺部破坏和炎症的程度是阻燃性MAC-PD中重新治疗必要性的关键决定因素.
- 这些发现可以为耐火性MAC-PD患者的治疗策略提供信息.
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