结核病与肺部健康杂志 ›› 2013, Vol. 2 ›› Issue (2): 119-121.

• 论著 • 上一篇    下一篇

非结核分枝杆菌肺病37例误诊分析

陈晓红,王琳,郑晓虎,余薇,林忠惠,刘坦业   

  1. 350008 福建医科大学临床教学医院 福建省福州肺科医院结核科
  • 收稿日期:2012-09-25 出版日期:2013-06-30 发布日期:2013-06-30
  • 通信作者: 陈晓红,Email:cxhong6886@126.com

Misdiagnosis analysis of 37 cases with pulmonary disease caused by nontuberculosis mycobacteria

CHEN Xiao-hong,WANG Lin,ZHENG Xiao-hu,YU Wei,LIN Zhong-hui,LIU Tan-ye   

  1. Department of Tuberculosis,Fuzhou Pulmonary Hospital Clinical Teaching Hospital of Fujian Medical University, Fuzhou 350008,China
  • Received:2012-09-25 Online:2013-06-30 Published:2013-06-30
  • Contact: CHEN Xiao-hong,Email:cxhong6886@126.com

摘要: 目的提高对非结核分枝杆菌(NTM)肺病的认识。方法回顾性分析福州肺科医院于2008年1月至2011年10月确诊的NTM肺病37例的临床资料。结果37例非结核分枝杆菌肺病均经菌型鉴定证实为NTM。误诊为肺结核20例(54.1%),支气管扩张或肺结核合并支气管扩张18例(48.6%),慢性支气管炎8例(21.6%),尘肺合并肺结核3例(8.1%),支气管哮喘、肺炎各2例。主要症状依次为咳嗽37例(100.0%)、咯痰34例(91.9%)、咯血30例(81.1%)。X线胸片示两侧受累者31例(83.8%),单侧者6例(16.2%),有空洞12例(32.4%)。治疗结果:目前治疗已满疗程的患者29例,痰菌转为阴性者24例(82.8%)。结论NTM肺病患者病程长,症状不特异,常易被误诊为肺结核和支气管扩张,抗结核治疗疗效差。

Abstract: Objective To improve the clinical recognition of nontuberculsis mycobacteria(NTM)pulmonary disease.Methods We analyzed retrospectively 37 cases of NTM pulmonary disease misdiagnosed by other diseases. All patients were admitted in our hospital during January 2008 and October 2011.Results Thirty-seven cases with NTM pulmonary disease were diagnosed through identification of mycobacterium strains by culture. These cases were misdiagnosed as pulmonary tuberculous in 20(54.1%)cases,bronchiectasis or pulmonary tuberculous complicated by bronchiectasis in 18(48.6%)cases,chronic bronchitis in 8(21.6%)cases,pneumoconiosis combined with tuberculosis in 3(8.1%)cases,bronchial asthma in 2 cases and pneumonia in 2 cases. Main clinical symptoms included cough in 37(100.0%),productive cough in 34(91.9%),haemoptysis in 30(81.1%),cavity 12(32.4%). Lesions distribution of chest radiology showed 31 cases in bilateral lung field and 6 cases in unilateral lung field. There were 12 cases with cavities in chest radiology. Among 29 cases completed chemotherapy duration,24 cases achieved sputum negative conversion. The sputum conversion rate was 82.8%.Conclusion NTM pulmonary disease is characterized by long course of disease and nonspecific symptoms. Most cases are commonly misdiagnosed by pulmonary tuberculosis and bronchiectasis. The efficacy with antituberculous therapy is poor.