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患有Mycobacterium avium复杂分离体的患者的死亡率和死亡原因,持续28年
Victor N Dahl1,2,3, Andreas A Pedersen4,5,6, Isik S Johansen4,5,6
1Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Open forum infectious diseases
|November 11, 2025
概括
由于Mycobacterium avium复合体 (MAC) 疾病,特别是肺部MAC的死亡率,尽管治疗得到了改进,但仍然显著. 风险因素包括年龄,男性性别,传播疾病和并发病,慢性呼吸道疾病和艾滋病毒是导致死亡的主要原因.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 非结核菌 (NTM) 疾病主要是由Mycobacterium avium复合体 (MAC) 引起的,是日益严重的全球健康问题.
- 有限的数据存在于MAC特定的死亡率和死亡原因.
- 这项研究通过调查MAC分离物患者的死亡模式来解决知识差距.
研究的目的:
- 调查诊断出Mycobacterium avium复合体 (MAC) 疾病的患者的死亡率和死亡原因.
- 确定与MAC患者死亡率增加相关的风险因素.
- 分析近三十年来与MAC相关的死亡率的趋势.
主要方法:
- 一项全国性的丹麦研究 (1991-2018) 分析了2,027名患有MAC分离物的患者的数据.
- 患者被分为肺 (PMAC),肺外 (EMAC) 或传播 (DMAC) 疾病组.
- 考克斯回归模型用于估计死亡率的调整危险比率 (aHR),控制年龄,性别,疾病类型和并发症.
主要成果:
- 一年死亡率为19% (PMAC),15% (EMAC) 和52% (DMAC),分别在10年内上升至68%,22%和84%.
- 随着时间的推移,死亡率下降,特别是EMAC和DMAC.
- 关键的死亡风险因素包括年龄 (aHR 1.04),男性性别 (aHR 1.85),DMAC (aHR 2.66) 和更高的并发症负担 (aHR 1.21).
结论:
- 肺部MAC (PMAC) 继续与大量的死亡率相关,尽管近30年的治疗进展.
- 在这项研究中发现的死亡率趋势和风险因素可以帮助临床医生为不同患者群体提供更精确的预后.
- 慢性呼吸道疾病和艾滋病毒被确定为MAC疾病患者的主要死亡原因.
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