胞内分枝杆菌肺病与堪萨斯分枝杆菌肺病临床特征分析

doi:10.3969/j.issn.2096-8493.20210049

摘要/Abstract

摘要：

分析苏州市第五人民医院2014年3月至2021年4月确诊的168例胞内分枝杆菌肺病(胞内组)与90例堪萨斯分枝杆菌肺病(堪萨斯组)患者的临床资料(包括性别、年龄、吸烟史、淋巴细胞亚群检测结果,以及并发肺部基础疾病、免疫系统疾病、其他系统疾病)。结果显示,胞内组患者在男性[47.62%(80/168)]、平均年龄[(62.23±1.01)岁]、吸烟史[5.36%(9/168)]、并发肺部基础疾病[58.93%(99/168)]、并发高血压[15.48%(26/168)]、并发其他系统疾病[20.83%(35/168)]、CD4⁺T淋巴细胞表达率[(34.82±0.73)%]、NK细胞表达率[(21.26±0.94)%]等方面与堪萨斯组[分别为91.11%(82/90)、(45.82±1.58)岁、18.89%(17/90)、26.67%(24/90)、5.56%(5/90)、10.00%(9/90)、(38.66±1.03)%、(16.55±1.07)%]比较,差异均有统计学意义(χ²=47.447,P=0.000;t=4.145,P=0.000;χ²=11.842,P=0.001;χ²=24.452,P=0.000;χ²=5.456,P=0.020;χ²=4.862,P=0.027;t=-3.058,P=0.003;t=3.117,P=0.002)。胞内分枝杆菌肺病与堪萨斯分枝杆菌肺病在患者性别、年龄、并发基础疾病,以及免疫细胞学检查等临床特征方面均有差异,对两种疾病的临床鉴别诊断有一定参考价值。

关键词: 肺疾病, 胞内分枝杆菌, 堪萨斯分枝杆菌, 疾病特征, 对比研究

Abstract:

The clinical data (including sex, age, smoking history, lymphocyte subsets, and comorbidity of pulmonary diseases, immune system diseases and diseases of other systems) of 168 cases of Mycobacterium intracellulare pulmonary disease (intracellulare group) and 90 cases of Mycobacterium kansas pulmonary disease (kansas group) diagnosed in the Fifth People’s Hospital of Suzhou from March 2014 to April 2021 were analyzed. As it turned out, the intracellulare group patients were of significant differences from the Kansas group in a number of figures (the intracellulare group: male (47.62% (80/168)), average age ((62.23±1.01) years old), smoking history (5.36% (9/168)), complicated with pulmonary diseases (58.93% (99/168)), complicated with hypertension (15.48% (26/168)), complicated with diseases of other systems (20.83% (35/168)), the expression rates of CD4 ⁺T lymphocytes ((34.82±0.73) %) and NK cells ((21.26±0.94) %); the Kansas group: (91.11% (82/90), (45.82±1.58) years old, 18.89% (17/90), 26.67% (24/90),5.56% (5/90), 10.00% (9/90), (38.66±1.03) %, (16.55±1.07) %), (χ²=47.447, P=0.000; t=4.145, P=0.000; χ ²=11.842, P=0.001; χ ²=24.452, P=0.000; χ ²=5.456, P=0.020; χ ²=4.862, P=0.027; t=-3.058, P=0.003; t=3.117, P=0.002)). The clinical characteristics of Mycobacterium intracellulare pulmonary disease and Mycobacterium kansas pulmonary disease are different in sex, age, complicated diseases, and lymphocyte subsets, which has certain reference value for the clinical differential diagnosis of those two diseases.

Key words: Lung diseases, Mycobacterium intracellulare, Mycobacterium kansasii, Disease attributes, Comparative study

严瑾瑜, 邹涛, 郭健, 徐勇, 唐佩军, 冯彦军. 胞内分枝杆菌肺病与堪萨斯分枝杆菌肺病临床特征分析[J]. 结核与肺部疾病杂志, 2021, 2(3): 294-297. doi: 10.3969/j.issn.2096-8493.20210049

YAN Jin-yu, ZOU Tao, GUO Jian, XU Yong, TANG Pei-jun, FENG Yan-jun. Analysis of clinical features of Mycobacterium intracellulare pulmonary disease and Mycobacterium kansas pulmonary disease[J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 294-297. doi: 10.3969/j.issn.2096-8493.20210049

图/表 2

表1

表2

不同临床特征在两组患者中的分布情况

临床特征	胞内组(168例)	堪萨斯组(90例)	统计检验值	P值
吸烟[例(发生率,%)]	9(5.36)	17(18.89)	χ²=11.842	0.001
并发肺部基础疾病[例(发生率,%)]	99(58.93)	24(26.67)	χ²=24.452	0.000
肺气肿	28(16.67)	6(6.67)	χ²=5.122	0.024
慢性阻塞性肺疾病	24(14.29)	4(4.44)	χ²=4.894	0.027
肺结核	48(28.57)	9(10.00)	χ²=11.743	0.001
支气管扩张	55(32.74)	5(5.56)	χ²=24.262	0.000
肺纤维化	7(4.17)	0(0.00)	χ²=2.438	0.118
其他	21(12.50)	3(3.33)	χ²=5.837	0.016
并发免疫系统疾病[例(发生率,%)]	4(2.38)	3(3.33)	χ²=0.002	0.963
强制性脊柱炎	1(0.60)	1(1.11)	χ²=0.000	1.000
类风湿性关节炎	1(0.60)	1(1.11)	χ²=0.000	1.000
其他	2(1.19)	1(1.11)	χ²=0.000	1.000
糖皮质激素使用史[例(发生率,%)]	1(0.60)	2(2.22)	χ²=0.305	0.581
并发全身性基础疾病史[例(发生率,%)]	35(20.83)	8(8.89)	χ²=6.020	0.014
高血压	26(15.48)	5(5.56)	χ²=5.456	0.020
糖尿病	9(5.36)	3(3.33)	χ²=0.181	0.670
并发其他系统疾病[例(发生率,%)]	35(20.83)	9(10.00)	χ²=4.862	0.027
淋巴细胞亚群表达率(%, $x ¯$ ±s)
CD4⁺T淋巴细胞	34.82±0.73	38.66±1.03	t=-3.058	0.003
CD8⁺T淋巴细胞	25.82±0.72	26.98±1.14	t=-0.897	0.371
B淋巴细胞	11.96±0.50	11.73±0.57	t=0.285	0.776
NK细胞	21.26±0.94	16.55±1.07	t=3.117	0.002

表2

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年龄组 (岁)	胞内组						堪萨斯组
	男性		女性		合计		男性		女性		合计
	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)
15~29	2	2.50	0	0.00	2	1.19	7	8.54	1	12.50	8	8.89
30~44	5	6.25	12	13.64	17	10.12	33	40.24	4	50.00	37	41.11
45~59	11	13.75	20	22.73	31	18.45	27	32.93	2	25.00	29	32.22
60~74	45	56.25	48	54.54	93	55.36	9	10.97	1	12.50	10	11.11
≥75	17	21.25	8	9.09	25	14.88	6	7.32	0	0.00	6	6.67
合计	80	100.00	88	100.00	168	100.00	82	100.00	8	100.00	90	100.00