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非结核分枝杆菌(NTM)肺病:十大要点

Nontuberculous mycobacterial (NTM) lung disease: the top ten essentials.

作者信息

Aksamit Timothy R, Philley Julie V, Griffith David E

机构信息

Department of Medicine, Mayo Clinic College of Medicine, 200 First St. S.W., Rochester, MN 5590, USA.

University of Texas Health Sciences Center, 11937 U.S. Hwy 271, Tyler, TX 75708, USA.

出版信息

Respir Med. 2014 Mar;108(3):417-25. doi: 10.1016/j.rmed.2013.09.014. Epub 2013 Sep 25.

Abstract

This review will utilize essential questions about nontuberculous mycobacterial (NTM) lung disease to succinctly address important new developments in the pathogenesis, diagnosis and management of NTM lung disease with a focus on practical information and "bottom line" answers. 1) What do I tell my patients who ask, “where did I get this infection” and, “should I take showers”? 2) What is the connection between bronchiectasis and the acquisition of NTM lung infection? 3) What other factors are important in the pathogenesis of NTM lung disease? 4) Why does it seem that am I seeing more new NTM lung disease patients? 5) Why is the diagnosis of NTM lung disease so complicated and does the diagnosis of NTM lung infection obligate specific treatment? 6) Unlike traditional tuberculosis, what is behind the irrelevance of most in vitro susceptibility testing reports for NTM infections? 7) Is there anything new for the management of patients with Mycobacterium avium complex lung disease? How does the radiographic appearance influence treatment? 8) Is there anything new for the management of patients with Mycobacterium abscessus lung disease? 9) What about the management of other NTM respiratory pathogens? 10) Is there a role for the use of macrolide monotherapy for non-cystic fibrosis bronchiectasis?

摘要

本综述将利用关于非结核分枝杆菌(NTM)肺病的关键问题,简洁地阐述NTM肺病在发病机制、诊断和管理方面的重要新进展,重点关注实用信息和“关键”答案。1)对于那些问“我从哪里感染了这个病”以及“我应该洗澡吗”的患者,我该怎么回答?2)支气管扩张与NTM肺部感染的获得之间有什么联系?3)在NTM肺病的发病机制中,还有哪些其他因素很重要?4)为什么我似乎看到了更多新的NTM肺病患者?5)为什么NTM肺病的诊断如此复杂,NTM肺部感染的诊断是否必然需要特定治疗?6)与传统结核病不同,大多数NTM感染的体外药敏试验报告无关紧要的背后原因是什么?7)鸟分枝杆菌复合群肺病患者的管理有什么新进展?影像学表现如何影响治疗?8)脓肿分枝杆菌肺病患者的管理有什么新进展?9)其他NTM呼吸道病原体的管理情况如何?10)大环内酯类单药治疗在非囊性纤维化支气管扩张中是否有作用?

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