临床荟萃 ›› 2025, Vol. 40 ›› Issue (12): 1093-1097.doi: 10.3969/j.issn.1004-583X.2025.12.007

• 论著 • 上一篇    下一篇

结核和非结核分枝杆菌病患者临床特征及耐药性分析

栾军琴1, 高艳军2()   

  1. 1.陆军军医大学士官学校附属医院 检验科,河北 石家庄 050041
    2.河北省胸科医院 检验科,河北 石家庄 050041
  • 收稿日期:2025-09-11 出版日期:2025-12-20 发布日期:2025-12-30
  • 通讯作者: 高艳军,Email:gaoyanjun7610@163.com
  • 基金资助:
    河北省医学科学研究课题计划——非结核分枝杆菌耐药性与生物膜形成的相关性研究(20231230)

Clinical characteristics and drug resistance analysis of patients with tuberculosis and non-tuberculous mycobacterial disease

Luan Junqin1, Gao Yanjun2()   

  1. 1. Department of Clinical Laboratory,the Affiliated Hospital of Non-Commissioned Officer School, the Army Medical University,Shijiazhuang 050041,China
    2. Department of Clinical Laboratory, Hebei Chest Hospital,Shijiazhuang 050041,China
  • Received:2025-09-11 Online:2025-12-20 Published:2025-12-30
  • Contact: Gao Yanjun,Email:gaoyanjun7610@163.com

摘要:

目的 通过对结核和非结核分枝杆菌病临床特征及耐药性对比分析,为疾病的早期鉴别诊断和治疗提供一定的思路。方法 收集2022年1月-2024年12月确诊为结核病(结核组)和非结核分枝杆菌病(非结核组)患者信息,对其临床特征及耐药性进行回顾性分析。结果 结核组和非结核组标本来源主要为痰,结核组感染以15~40岁青壮年男性为主;非结核组以61岁以上老年人男性为主。结核组咳嗽(χ2=18.850,P<0.01)、咯血(χ2=31.780,P0.01),CT表现斑片影(χ2=11.680,P=0.001)、结节影(χ2=12.590,P<0.01)、支气管影(χ2=22.640,P<0.01)、高血压(χ2=12.600,P<0.01)、贫血(χ2=4.637,P=0.031)、糖尿病病史(χ2=34.330,P<0.01)、白细胞减少(χ2=9.470,P=0.002)和肺气肿(χ2=16.430,P<0.001)显著高于非结核组。结核组异烟肼耐药率较高,耐药率为22.65%,而非结核组对大部分结核药高度耐药。结论 结核病患者以青壮年居多,非肺结核分枝杆菌病以老年人为主,临床特征和药敏结果的差异为早期疾病的诊断和治疗提供一定思路。

关键词: 结核, 分枝杆菌感染, 非结核, 标本来源, 临床特征, 耐药性分析

Abstract:

Objective To provide insights for early differential diagnosis and treatment by comparatively analyzing the clinical features and drug-resistance patterns of tuberculosis (TB) and non-tuberculous mycobacterial (NTM) disease. Methods We retrospectively collected data on patients diagnosed with TB (TB group) and NTM disease (NTM group) from January 2022 to December 2024. Clinical characteristics and antimicrobial resistance profiles were analyzed and compared between the two groups. Results The specimens of TB group and NTM group mainly came from sputum. TB patients were predominantly young and middle-aged males aged 15-40 years,whereas NTM patients were mainly males aged 61 years and older. Compared with the NTM group,the TB group had significantly higher rates of cough (χ2=18.850,P<0.01),hemoptysis (χ2=31.780,P<0.01),and CT findings including patchy opacities (χ2=11.680,P=0.001),nodular lesions (χ2=12.590,P<0.01),and bronchial changes (χ2=22.640,P<0.01). The TB group also showed higher prevalences of hypertension (χ2=12.600,P<0.01),anemia (χ2=4.637,P=0.031),diabetes history (χ2=34.330,P<0.01),leukopenia (χ2=9.470,P=0.002),and emphysema (χ2=16.430,P<0.001). Drug-resistance analysis indicated a relatively high isoniazid resistance rate in the TB group (22.65%),whereas the NTM group exhibited high levels of resistance to most anti-tuberculosis drugs. Conclusion TB patients in this cohort were predominantly young to middle-aged adults,while NTM disease occurred mainly in elderly patients. The observed differences in clinical presentation and susceptibility profiles may assist early differential diagnosis and guide appropriate treatment strategies.

Key words: tuberculosis, mycobacterium infections, nontuberculous, specimen source, clinical features, drug-resistance-analysis

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