Mizutani S
Department of Medicine, Fukujuji Hospital, Tokyo, Japan.
Kekkaku. 1991 Jan;66(1):19-38.
By using DNA Probe, cases due to M. avium complex in Japan were grouped into those M. avium and M. intracellulare and their clinical patients were compared by multifactorial analysis. A total of 179 cases was studied (103 due to M. avium and 76 due to M. intracellulare). M. avium cases were found more commonly around Tokyo and north, whereas M. intracellulare cases were seen more frequently in the western part of Japan. Background factors (sex, age, past history, complications, bacterial status, mode of detection, and symptoms) were similar among the cases due to M. avium and M. intracellulare. No difference was seen in the chest X-ray. Weighing up to the disappearance of bacterial excretion revealed heavier in the quantity of bacterial excretion in M. avium cases, but not much in chemotherapy. In M. intracellulare cases on the other hand, chemotherapy played a more weighed role. In both groups, EB was weighed heavier among the drugs. Among the additionally used drugs, SM was useful in M. avium and KM in M. intracellulare. RFP was useful in combined therapy. The usefulness of INH was lower. In areas western to Osaka and vicinity, MAC was reported to exert favorable effect. In case this is true, higher prevalence of M. intracellulare and the use of KM, EB, RFP in these areas may explain such phenomena.
通过使用DNA探针，将日本鸟分枝杆菌复合群所致病例分为鸟分枝杆菌和胞内分枝杆菌病例，并通过多因素分析对其临床患者进行比较。共研究了179例病例（103例由鸟分枝杆菌引起，76例由胞内分枝杆菌引起）。鸟分枝杆菌病例在东京及北部地区更为常见，而胞内分枝杆菌病例在日本西部更为多见。鸟分枝杆菌和胞内分枝杆菌所致病例的背景因素（性别、年龄、既往史、并发症、细菌状态、检测方式及症状）相似。胸部X线检查未见差异。直至细菌排泄物消失的观察显示，鸟分枝杆菌病例的细菌排泄量更大，但化疗效果不明显。另一方面，在胞内分枝杆菌病例中，化疗起的作用更大。两组中，乙胺丁醇在药物中作用更为显著。在额外使用的药物中，链霉素对鸟分枝杆菌有效，卡那霉素对胞内分枝杆菌有效。利福平在联合治疗中有效。异烟肼的有效性较低。据报道，在大阪及其周边以西地区，鸟分枝杆菌复合群有良好疗效。如果属实，这些地区胞内分枝杆菌的较高患病率以及卡那霉素、乙胺丁醇、利福平的使用可能解释了这种现象。
