PDF(Pubmed)
Abstract：
Multidrug therapy for Mycobacterium avium complex pulmonary disease (MAC-PD) results in negative sputum cultures. However, the prognostic value of this treatment approach remains unclear. This study aimed to clarify whether multidrug therapy reduces the incidence of events related to MAC-PD and improves the mortality rate. Patients who met the diagnostic criteria for MAC-PD at our hospital between 2003 and 2019 were retrospectively evaluated using medical records. Events related to MAC-PD were defined as hospitalisation for haemoptysis or respiratory infection and the development of chronic respiratory failure. There were 90 and 108 patients in the multidrug and observation groups, respectively. The median observation period was 86 months. Intergroup differences in body mass index, proportion of patients with cavities, and erythrocyte sedimentation rate were not significant. However, the observation group was older with a higher mean age (multidrug group: 62 years, observation group: 69 years; P < 0.001) and had a higher proportion of male patients (multidrug group: 13/90 [14.4%], observation group: 35/108 [32.4%]; P < 0.01). Furthermore, intergroup differences in the incidence of events related to MAC-PD (multidrug group: 26.69/1000 person-years, observation group: 25.49/1000 person-years), MAC-PD-associated mortality rate (multidrug group: 12.13/1000 person-years, observation group: 12.74/1000 person-years), and total mortality (multidrug group: 24.26/1000 person-years, observation group: 29.50/1000 person-years) were not significant. Many patients relapse even after multidrug therapy, and our findings suggest that multidrug therapy has no effect in preventing the onset of respiratory events or prolonging life expectancy.
摘要：
鸟分枝杆菌复合肺病（MAC-PD）的多药治疗导致痰培养阴性。然而,这种治疗方法的预后价值尚不清楚.本研究旨在阐明多药治疗是否能降低MAC-PD相关事件的发生率并提高死亡率。在2003年至2019年间在我院符合MAC-PD诊断标准的患者使用病历进行回顾性评估。与MAC-PD相关的事件被定义为因咯血或呼吸道感染以及慢性呼吸衰竭的发展而住院。多药和观察组分别有90例和108例患者，分别。中位观察期为86个月。体重指数的组间差异，有龋齿的患者比例，红细胞沉降率无显著性差异。然而,观察组年龄较大，平均年龄较高(多药组：62岁，观察组:69岁;P<0.001),男性患者比例较高(多药组:13/90[14.4%],观察组:35/108[32.4%];P<0.01)。此外，与MAC-PD相关的事件发生率的组间差异(多药组:26.69/1000人年,观察组：25.49/1000人年），MAC-PD相关死亡率（多药组：12.13/1000人年，观察组：12.74/1000人年），和总死亡率（多药组：24.26/1000人年，观察组:29.50/1000人年)均不显著。许多患者即使在多药治疗后也会复发，我们的研究结果表明,多药治疗对预防呼吸事件的发生或延长预期寿命没有效果.
