四川地区非结核分枝杆菌肺病的菌种分布和临床特征分析

doi:10.19871/j.cnki.xfcrbzz.2026.01.008

摘要/Abstract

摘要： 目的了解并分析近年来四川地区非结核分枝杆菌（non-tuberculous Mycobacteria,NTM）肺病菌种分布和临床特点,为NTM肺病的临床诊治提供参考依据。方法收集2022年1月至2024年12月就诊于成都公共卫生临床医疗中心且诊断为NTM肺病患者的病历资料,分析NTM肺病患者的菌种分布及相关的临床特征。结果共收集确诊为NTM肺病病例235例,男性患者141例（60%）多于女性患者94例（40%),好发于60岁以上人群（134例,占57.02%）。235例患者中共检出11种菌株,前3位优势菌株分别为胞内分枝杆菌（82例,34.89%）、鸟分枝杆菌（55例,23.40%）、脓肿分枝杆菌（51例,21.70%）。NTM肺病常见合并症依次为既往结核病史（64例,27.23%）、支气管扩张（53例,22.55%）、慢性阻塞性肺疾病（40例,17.02%）、HIV感染（34例,14.47%）、尘肺（15例,6.38%）、糖尿病（15例,6.38%）、恶性肿瘤（8例,3.40%）、风湿免疫性疾病（7例,2.98%）。女性比男性更易合并支气管扩张,而男性更易合并慢性阻塞性肺疾病、尘肺及HIV感染。NTM肺病的主要临床症状为咳嗽、咳痰（203例,86.38%）、咯血（83例,35.32%）、气促（77例,32.77%）、发热（40例,17.02%）、消瘦（32例,13.62%）、胸痛（18例,7.66%）,女性比男性易出现咯血,而男性比女性更易出现发热、胸痛（P<0.05）。NTM肺病主要影像学表现为肺部结节、空洞、支气管扩张、肺气肿及肺毁损。男性比女性更易出现肺气肿和肺毁损（P<0.05）。结论四川地区NTM以胞内分枝杆菌、鸟分枝杆菌及脓肿分枝杆菌为主,其临床特征与肺结核相似,需及时准确行分枝杆菌菌种鉴定,为临床诊疗提供依据。

关键词: 非结核分枝杆菌, 非结核分枝杆菌肺病, 菌种鉴定, 临床特征

Abstract: Objective To investigate and analyze the distribution of bacterial strains and clinical characteristics of non-tuberculous Mycobacteria (NTM) pulmonary disease in the Sichuan region in recent years, providing a reference for clinical diagnosis and treatment. Method Medical records of patients diagnosed with NTM pulmonary disease at Chengdu Public Health Clinical Medical Center from January 2022 to December 2024 were collected. The species distribution and related clinical features of NTM pulmonary disease were analyzed. Result A total of 235 confirmed NTM pulmonary disease cases were collected. Male patients (141 cases, 60%) outnumbered female patients (94 cases, 40%), with the disease predominantly affecting individuals aged 60 years and above (134 cases, 57.02%). Among the 235 patients, 11 species of NTM were identified. The top three predominant species were Mycobacterium intracellulare (82 cases, 34.89%), Mycobacterium avium (55 cases, 23.40%), and Mycobacterium abscessus (51 cases, 21.70%). Common comorbidities of NTM pulmonary disease included a history of tuberculosis (64 cases, 27.23%), bronchiectasis (53 cases, 22.55%), chronic obstructive pulmonary disease (40 cases, 17.02%), HIV infection (34 cases, 14.47%), pneumoconiosis (15 cases, 6.38%), diabetes (15 cases, 6.38%), malignant tumors (8 cases, 3.40%), and rheumatic immune diseases (7 cases, 2.98%). Females were more likely to have bronchiectasis, while males were more prone to chronic obstructive pulmonary disease, pneumoconiosis, and HIV infection. The main clinical symptoms of NTM pulmonary disease were cough and expectoration (203 cases, 86.38%), hemoptysis (83 cases, 35.32%), shortness of breath (77 cases, 32.77%), fever (40 cases, 17.02%), weight loss (32 cases, 13.62%), and chest pain (18 cases, 7.66%). Females were more likely to experience hemoptysis, while males were more susceptible to fever and chest pain(P<0.05）. The primary imaging manifestations of NTM pulmonary disease included pulmonary nodules, cavities, bronchiectasis, emphysema, and pulmonary destruction. Males were more likely to exhibit emphysema and pulmonary destruction compared to females(P<0.05). Conclusion In the Sichuan region, NTM pulmonary disease is primarily caused by Mycobacterium intracellulare, Mycobacterium avium, and Mycobacterium abscessus. Its clinical features resemble those of pulmonary tuberculosis. Timely and accurate identification of Mycobacterium species provides essential guidance for clinical diagnosis and treatment.

Key words: Non-tuberculous Mycobacteria, Non-tuberculous Mycobacterial pulmonary disease, Distribution of bacterial strains, Clinical features

中图分类号:

R563
R183.7

朱红梅, 时正雨, 李秀, 黄涛. 四川地区非结核分枝杆菌肺病的菌种分布和临床特征分析[J]. 新发传染病电子杂志, 2026, 11(1): 50-54.

Zhu Hongmei, Shi Zhengyu, Li Xiu, Huang Tao. Analysis of the distribution of bacterial strains and clinical characteristics of non-tuberculous Mycobacteria pulmonary disease in Sichuan[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(1): 50-54.

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