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首页> 外文期刊>Medical mycology: official publication of the International Society for Human and Animal Mycology >The risk factors for developing of chronic pulmonary aspergillosis in nontuberculous mycobacteria patients and clinical characteristics and outcomes in chronic pulmonary aspergillosis patients coinfected with nontuberculous mycobacteria
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The risk factors for developing of chronic pulmonary aspergillosis in nontuberculous mycobacteria patients and clinical characteristics and outcomes in chronic pulmonary aspergillosis patients coinfected with nontuberculous mycobacteria

机译：非结核分枝杆菌患者发生慢性肺曲霉病的危险因素以及合并非结核分枝杆菌的慢性肺曲霉病患者的临床特征和结局

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摘要

Patients with chronic pulmonary aspergillosis (CPA) have a poor prognosis and CPA occurs in patients with various underlying diseases. Recently, the number of patients with CPA complicated by nontuberculous mycobacteria (NTM) has increased. Additionally, complications of both diseases have several problems like drug interactions. Since the impact of NTM on the outcome of CPA is not well understood, we investigated the risk factors for developing CPA and the clinical characteristics of CPA patients with or without NTM. We retrospectively investigated the medical records of NTM and CPA patients who were admitted to Nagasaki University Hospital between April 2008 and September 2013. Comorbid diseases, causativemicroorganisms, radiological findings, and outcomes were evaluated. During the study period, 82 and 41 patients were diagnosed as having NTM and CPA, respectively. Nine patients were coinfected with NTM and CPA, and cavitary type NTM and steroid usage were independent risk factors of development of CPA. Mortality rates in the coinfection group were significantly higher than those of the NTM without CPA group (P = .003, log-rank test). The rate of treatment initiation in the co-infection group (33.3%) was significantly lower than in the CPA without NTM group (84.4%) (P = .006). However, there were no significant differences in cumulative survival rate between both groups (P = .760, log-rank test). Cavity formation and steroid usage were the independent risk factors for NTM patients to develop CPA within long observation period, and development of CPA made outcomes poor. It is important to diagnose the development of CPA early and initiate treatment for CPA.
机译：患有慢性肺曲霉病（CPA）的患者预后较差，并且CPA发生在患有各种基础疾病的患者中。最近，CPA并发非结核分枝杆菌（NTM）的患者人数有所增加。另外，两种疾病的并发症都有一些问题，例如药物相互作用。由于尚未很好地了解NTM对CPA结局的影响，因此我们调查了发展CPA的危险因素以及有无NTM的CPA患者的临床特征。我们回顾性调查了2008年4月至2013年9月在长崎大学医院住院的NTM和CPA患者的病历。对合并症，病原微生物，放射学表现和结局进行了评估。在研究期间，分别有82和41位患者被诊断出患有NTM和CPA。 9名患者同时感染了NTM和CPA，空化NTM和类固醇的使用是CPA发生的独立危险因素。合并感染组的死亡率显着高于没有CPA组的NTM（P = 0.003，对数秩检验）。共感染组的治疗开始率（33.3％）显着低于无NTM组的CPA（84.4％）（P = .006）。但是，两组之间的累积生存率没有显着差异（P = .760，对数秩检验）。腔形成和类固醇使用是NTM患者在较长的观察期内发展CPA的独立危险因素，而CPA的发展会使结局变差。尽早诊断CPA的发展并开始CPA的治疗很重要。

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