非结核菌 (NTM) 和COPD:一个多中心前性研究
Eva Tabernero1,2, Amaia Aramburu3, Raquel Sanchez4
1Cruces University Hospital, Barakaldo, Spain evataberna@yahoo.es.
非结核菌 (NTM) 经常从慢性阻塞性肺病 (COPD) 患者中分离出来. 导致NTM隔离的危险因素包括体重低,α-1抗素缺乏,吸入性皮质类固醇和癌症.
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:
- 非结核性真菌菌 (NTM) 的气道分离物正在增加,特别是在已经存在肺损伤的患者中.
- 吸入的皮质类固醇可能会增加NTM肺部疾病的风险.
- 在慢性阻塞性肺病 (COPD) 患者中NTM隔离患病率的数据有限.
研究的目的:
- 根据ATS/ERS/IDSA 2020标准确定高风险的COPD患者的NTM隔离患病率和NTM肺病发病率.
- 在COPD患者中确定NTM隔离和NTM肺部疾病发展的风险因素.
主要方法:
- 前性,多中心,观察性研究.
- 从高风险的COPD患者每年收集三份唾液样本进行培养 (标准,真菌菌,真菌).
- 包括患有支气管扩展后FEV1<50%和/或≥2次恶化/年,随访12个月的患者.
主要成果:
- 在15% (39/258) 的患者中隔离了NTM;3% (8/258) 满足了NTM疾病的标准.
- 最常见的物种是Mycobacterium avium复合体 (MAC).
- 导致NTM隔离的危险因素:体重低,α-1抗素 (AAT) 缺乏,吸入性皮质类固醇,癌症.
- 与体重指数<21.21相关的NTM疾病.
结论:
- 在COPD患者中,NTM隔离比预期的更常见,影响治疗决策.
- 低体重,AAT缺乏,吸入性皮质类固醇使用和癌症与COPD中NTM隔离有关.
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