中国防痨杂志2017，Vol.39Issue(4)：391-396,6.DOI:10.3969/j.issn.1000-6621.2017.04.016
277例非结核分枝杆菌肺病治疗状况分析
Analysis on treatment situation of 277 cases with non-tuberculous mycobacterial lung disease
摘要
Abstract
Objective To analyze the treatment situation of the patients with non-tuberculous mycobacterial (NTM) lung disease in our hospital,and to explore the standardization and rationality of the treatment for this sort of patients.Clinical data and information,including demography characteristics,drug susceptibility testing (DST) results and bacterial species identification results,treatment regimens and treatment outcomes,were collected from 277 patients who had been confirmed to have NTM lung diseases in the 3rd People's Hospital of Shenzhen from January 2011 to June 2015.The collected data and information were analyzed.Methods Clinical data and information,including demography characteristics,drug susceptibility testing (DST) results and bacterial species identification results,treatment regimens and treatment outcomes,were collected from 277 patients who had been confirmed to have NTM lung diseases in the 3rd People's Hospital of Shenzhen from January 2011 to June 2015.The collected data and information were analyzed.Results In 277 cases with NTM lung disease,58.5％ (162/277) of cases received anti-TB treatment while 41.5％ (115/277) of cases did not,and the cure rate was only 15.4％ (25/162).Among the NTM patients who received the treatment,some patients got improvement.The improvement rate was 47.6％ (69/145) and the rate of failure was 52.4％ (76/145).The difference between the improvement rate and the failure rate was statistically significant (x2=13.05,P =0.042).The rate that the patients getting better or being stable in the treatment group was 85.5％ (124/145) while it was 77.9％ (81/104) in the nou-treatment group,and those two rates (had no significant difference (x2 =2.43,P=0.119).30.2％ (49/162) of patients received the treatment with 6 to 9 months duration.The DST results showed that 77.3％ (214/277) of the patients with NTM infection had very high primary resistance to the first-line anti-TB drugs and some second-line anti-TB drugs,namely the primary resistance rate to INH,RFP,Sm,Cm and PAS was over 80.0％ respectively.The most commonly used drugs were Clr (71.6％,116/162),EMB (56.8％,92/162),Mfx (29.6％,48/162),Lfx (28.4％,46/162),Pto (14.8％,24/162),Am (13.6％,22/162),Rfb (12.3％,20/162),RFP (9.9％,16/162) and Cm (5.6％,9/162).The most effective drugs were Am (86.4％,19/22),Pto (79.2％,19/24),Cm (77.8％,7/9),Mfx (64.6％,31/48),Lfx (58.7％,27/46),RFP (56.3％,9/16),Clr (54.3％,63/116),EMB (52.2％,48/92) and Rfb (40.0％,8/20);53.1％ (77/145) of the NTM infected patients received the treatment with 3-drug combination regimens;the patients who received the treatment with 4-drug combination regimens (85.7％,24/28) had the best treatment outcomes.Conclusion The treatment principals for NTM lung disease which have been recommended by the national experts are not well followed.So the treatment to the NTM infection patients is not standardized in practice and the treatment outcomes are poor.关键词
分枝杆菌感染,非典型性/肺炎,细菌性/药物疗法,联合/治疗,临床研究性Key words
Mycobacterium infections, atypical/Pneumonia, bacterial/Drug therapy, combination/Therapies, investigational引用本文复制引用
邓国防,付亮,唐怡敏,郑俊峰,叶涛生,张培泽..277例非结核分枝杆菌肺病治疗状况分析[J].中国防痨杂志,2017,39(4):391-396,6.基金项目
深圳市结核病临床重点专科(深卫人医政(2011)107号)(2011-12-29) （深卫人医政(2011）
