Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Front Public Health. 2022 Aug 1;10:912651. doi: 10.3389/fpubh.2022.912651. eCollection 2022.
According to the existing data, the incidence and prevalence of non-tuberculous mycobacteria (NTM) are increasing worldwide. The risk factors and mental health status of patients with NTM lung disease are important and deserve our attention. A total of 180 patients with NTM lung disease hospitalized from January 2018 to December 2021 were selected as the NTM group, and 90 patients with non-severe community-acquired pneumonia (CAP) who were hospitalized during the same period were selected as the control group. The Symptom Checklist-90 (SCL-90) was used to assess the mental health status of the patients. The data were analyzed using descriptive statistics, logistic regression, and receiver operating characteristic (ROC) curves. There were no significant differences in age, sex, marital status, or smoking history between the two groups ( > 0.05), but there were significant differences in educational level, underlying diseases, occupation, living environment, and body mass index (BMI) ( < 0.01). According to the classification of basic diseases, bronchiectasis was found in 82 (45.6%) patients, followed by hypertension in 66 (36.7%) patients, and chronic obstructive pulmonary disease (COPD) in 39 (21.7%) patients. The NTM strains were identified caused 41 cases (22.8%), followed by and , each with 35 cases (19.4%), and with 32 cases (17.8%). The SCL-90 found that 160 (88.9%) of 180 patients with NTM lung disease had developed mental health problems, among which the four highest-scoring factors were anxiety (ANX: 29.4%), depression (DEPR: 18.8%), sleep and diet (SD: 16.9%), and somatization (SOM: 11.3%). Through multivariate logistic regression analysis, it was found that educational level, underlying diseases, living environment, and BMI were independent risk factors for the occurrence of NTM lung disease ( < 0.01). The Hosmer-Lemeshow test was used to check the model's fitness. The ROC curve showed that the area under the curve (AUC) was 0.896, the sensitivity was 83.3%, and the specificity was 85.6%. Patients with NTM lung disease have many risk factors and prominent mental health problems that may require interventions during the process of clinical diagnosis and treatment.
根据现有数据,非结核分枝杆菌(NTM)的发病率和患病率在全球范围内呈上升趋势。NTM 肺病患者的危险因素和心理健康状况值得我们关注。选取 2018 年 1 月至 2021 年 12 月期间住院的 180 例 NTM 肺病患者为 NTM 组,同期选取 90 例非重症社区获得性肺炎(CAP)患者为对照组。采用症状自评量表 90 项(SCL-90)评估患者的心理健康状况。采用描述性统计、logistic 回归和受试者工作特征(ROC)曲线分析数据。两组患者在年龄、性别、婚姻状况和吸烟史方面无显著差异(>0.05),但在文化程度、基础疾病、职业、生活环境和体质指数(BMI)方面存在显著差异(<0.01)。根据基础疾病分类,发现支气管扩张 82 例(45.6%),其次是高血压 66 例(36.7%),慢性阻塞性肺疾病(COPD)39 例(21.7%)。NTM 株由 41 例(22.8%)引起,其次是 和 ,各 35 例(19.4%), 32 例(17.8%)。SCL-90 发现,180 例 NTM 肺病患者中有 160 例(88.9%)出现心理健康问题,其中得分最高的四个因素是焦虑(ANX:29.4%)、抑郁(DEPR:18.8%)、睡眠和饮食(SD:16.9%)和躯体化(SOM:11.3%)。多因素 logistic 回归分析发现,文化程度、基础疾病、生活环境和 BMI 是 NTM 肺病发生的独立危险因素(<0.01)。Hosmer-Lemeshow 检验用于检查模型的拟合度。ROC 曲线显示曲线下面积(AUC)为 0.896,敏感度为 83.3%,特异度为 85.6%。NTM 肺病患者有许多危险因素,心理健康问题突出,在临床诊断和治疗过程中可能需要干预。