Kamei Ryohei, Sawahata Michiru, Nakayama Masayuki, Yamada Toshiyuki, Taniguchi Nobuyuki, Bando Masashi, Hagiwara Koichi
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Japan.
Department of Clinical Laboratory Medicine, Jichi Medical University, Japan.
J Rural Med. 2023 Jul;18(3):168-174. doi: 10.2185/jrm.2023-001. Epub 2023 Jul 7.
To identify the prevalence of risk factors for pulmonary non-tuberculous mycobacterial (NTM) disease in a Japanese population. We reviewed 337 consecutive Japanese patients (210 women) with pulmonary NTM disease, including 225 patients with Mycobacterium avium complex (MAC) disease (95.8%) at our hospital during 2006-2017. We calculated the prevalence of risk factors reported in Western countries among mycobacterial species. Pulmonary MAC disease cases comprised 78.2% of pulmonary NTM patients in their 40s, increasing to 100% at age ≥80 years. Body mass index (BMI) was <18.5 in approximately 40% of patients, which was significantly higher than the prevalence of underweight in the Japanese population. The percentage of male heavy smokers (Brinkman index ≥600) was 58.2% of pulmonary NTM disease and was high for all mycobacterial species. In pulmonary MAC disease, systemic factors were observed in the order of malignant tumors (other than lung cancer), diabetes, rheumatoid arthritis, and tuberculosis. Local factors were observed in the order of bronchiectasis, chronic obstructive pulmonary disease, lung cancer, and bronchial asthma. The risk factors reported in Western countries were relatively highly prevalent among Japanese pulmonary NTM disease patients. This observation may help elucidate disease onset mechanisms.
确定日本人群中肺部非结核分枝杆菌（NTM）病危险因素的患病率。我们回顾了我院2006年至2017年间连续收治的337例日本肺部NTM病患者（210例女性），其中包括225例鸟分枝杆菌复合群（MAC）病患者（95.8%）。我们计算了西方国家报道的分枝杆菌菌种中危险因素的患病率。肺部MAC病病例在40多岁的肺部NTM患者中占78.2%，在≥80岁时增至100%。约40%的患者体重指数（BMI）<18.5，这显著高于日本人群中体重过轻的患病率。男性重度吸烟者（ Brinkman指数≥600）在肺部NTM病患者中占58.2%，在所有分枝杆菌菌种中这一比例都很高。在肺部MAC病中，观察到的全身因素依次为恶性肿瘤（非肺癌）、糖尿病、类风湿关节炎和结核病。局部因素依次为支气管扩张、慢性阻塞性肺疾病、肺癌和支气管哮喘。西方国家报道的危险因素在日本肺部NTM病患者中相对较为普遍。这一观察结果可能有助于阐明疾病的发病机制。
