脓肿分枝杆菌肺病47例临床分析

目的　提高对脓肿分枝杆菌肺病临床表现的认识。方法 对1998年1月—2001年12月收治的脓肿分枝杆菌肺病47例临床资料进行回顾分析。结果 无合并结核分枝杆菌肺病32例(68.1%),合并结核分枝杆菌肺病15例(31.9%)。有反复抗结核病治疗史31例(66%)。主要症状为咳嗽、咳痰、咯血(痰)。X线胸片中,病灶在3个肺野以上37例(78.7%);两侧受累者28例(59.6%),右侧15例(31.9%),左侧4例(8.5%),病灶内有空洞23例(48.9%),其中右上空洞16例(69.6%),左上空洞9例(39.1%)。对H、R、S、E、Th1321、D、L耐药率高,对A、C、V、CTM耐药率相对低。结论 脓肿分枝杆菌肺病病程长,症状无特异,耐药率高,抗结核治疗疗效差。

A Clincal analysis on 47 cases with Mycobacterium abscessus pulmonary disease

Objective To improve the understanding of Mmycobacterium abscessus(M.abscessus)pulmonary disease.Method Retrospective analyze the information of 47cases with M.abscessus pulmonary disease from Jan.1998 to Dec.2001.Results There were 15 cases of M.abscessus pulmonary disease accompanied with pulmonary tuberculosis,whereas the other 32 cases without pulmonary tuberculosis.31 cases were treated with anti-tuberculosis drugs before diagnosis.The main clinical symptoms included cough,expectoration with sputum,hemoptysis.On the chest X-ray,78.7% patients’ disease focuses were distributed over 3 pulmonary fields.59.6%cases in X-ray chest film were seen lesions bilaterally,31.9% in right side and 8.5%in the left.48.9% patients were accompanied with cavities.The resistant rates were high to isoniazid,rifampin,streptomycin,ethambulol,protionamide,pasiniazide and rifapentine,while lower to amikacin,capreomycin,levofloxacin,and clarithromycin relatively.Conclusion M.abscessus pulmonary disease is characterized with long progress,nonspecific symptoms,high resistant rate to anti-tuberculosis drug and unsatisfactory result of therapy.