摘要目的 比较鸟-胞内分枝杆菌复合菌组(MAC)肺病和脓肿分枝杆菌肺病临床表现的差异.方法 回顾性分析北京胸科医院2010-2011年新发并有完整资料的MAC肺病18例和脓肿分枝杆菌肺病9例的临床资料,旨在提高对NTM肺病的诊断水平.结果 MAC肺病和脓肿分枝杆菌肺病患者在性别、年龄、体重指数、基础疾病、症状和痰抗酸染色阳性等方面无显著差别.MAC肺病以上叶空洞型较常见(13/18),脓肿分枝杆菌肺病以结节支气管扩张型较常见(8/9)；脓肿分枝杆菌肺病患者双肺微结节(8/9)、树芽征(7/9)和多发支气管扩张(8/9)较MAC肺病(7/18、6/18和5/18)常见,MAC肺病患者上叶空洞(13/18)较脓肿分枝杆菌肺病(2/9)常见.结论 MAC肺病和脓肿分枝杆菌肺病的许多特点相类似,但双肺微结节、树芽征和多发支气管扩张多见于脓肿分枝杆菌肺病,上叶空洞多见于MAC肺病.

abstractsObjective To compare the clinical manifestations of nontuberculous mycobacterial (NTM) pulmonary diseases caused by Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus.Methods The clinical manifestations of 18 patients with MAC and 9 patients with Mycobacterium abscessus pulmonary diseases diagnosed from 2010 to 2011 were reviewed. Results There were no significant differences in the gender,age,body mass index,predisposed diseases,symptoms and positive sputum acid-fast bacillus between MAC and Mycobacterium abscessus groups.Upper lobe cavities were more frequently observed in the MAC group (13/18),whereas nodular bronchiectatic changes were more frequent in the Mycobacterium abscessus group (3/9). Compared with MAC pulmonary diseases,several imaging characteristics were more common in the Mycobacterium abscessus group,including bilateral micronodules (Mycobacterium abscessus group 8/9 vs MAC group 7/18 ),tree-in-bud sign (Mycobacterium abscessus group 7/9 vs MAC group 6/18) and multiple bronchiectesis (Mycobacterium abscessus group 8/9 vs MAC group 5/18). Conclusions There was considerable overlap in clinical characteristics of MAC and Mycobacterium abscessus pulmonary diseases.However,bilateral micronodules,tree-in-bud sign and multiple bronchiectesis were more frequently seen in Mycobacterium abscessus than in MAC pulmonary diseases,while upper lobe cavities were more frequently seen in MAC than in Mycobacterium abscessus pulmonary diseases.