Toyoda T, Aoyagi T, Saito H
Department of Internal Medicine, National Sanatorium Higashisaitama Hospital, Saitama, Japan.
Kekkaku. 1993 Jan;68(1):63-9.
In recent years, it has been made easy to identify Mycobacterium avium and M. intracellulare by DNA-probe test. To evaluate possible clinical differences between the lung diseases due to M. avium and those due to M. intracellulare, we studied a total of 248 cases (136 due to M. avium and 112 due to M. intracellulare). M. avium cases were found more frequently in the eastern part of Japan, whereas M. intracellulare cases were seen more frequently in the western part of Japan. There was no significant difference between M. avium cases and M. intracellulare cases in sex, age, complications, chief complaint, body weight, tuberculin skin test, erythrocyte sedimentation rate, serum protein content, findings of chest X ray. M. avium cases were more frequently detected by health examination. M. avium was more susceptible to cycloserine than M. intracellulare. On the other hand, M. intracellulare was more susceptible to streptomycin and kanamycin. The prognosis of M. intracellulare cases were better than M. avium cases, when compared only the patients who showed positive tuberculin skin test.
近年来,通过DNA探针检测已能轻松鉴定鸟分枝杆菌和胞内分枝杆菌。为评估由鸟分枝杆菌引起的肺部疾病与由胞内分枝杆菌引起的肺部疾病之间可能存在的临床差异,我们共研究了248例病例(136例由鸟分枝杆菌引起,112例由胞内分枝杆菌引起)。鸟分枝杆菌病例在日本东部更为常见,而胞内分枝杆菌病例在日本西部更为常见。鸟分枝杆菌病例和胞内分枝杆菌病例在性别、年龄、并发症、主要症状、体重、结核菌素皮肤试验、红细胞沉降率、血清蛋白含量、胸部X线检查结果方面无显著差异。鸟分枝杆菌病例通过健康检查检出的频率更高。鸟分枝杆菌比胞内分枝杆菌对环丝氨酸更敏感。另一方面,胞内分枝杆菌对链霉素和卡那霉素更敏感。仅比较结核菌素皮肤试验呈阳性的患者时,胞内分枝杆菌病例的预后优于鸟分枝杆菌病例。