支气管哮喘合并侵袭性肺曲霉菌病5例并文献复习

Invasive pulmonary aspergillosis in patients with asthma:five cases reports and literature review

目的提高对支气管哮喘患者合并侵袭性肺曲霉菌病的诊断及治疗。方法分析2010年1月至2011年5月在我院呼吸科住院的5例支气管哮喘并侵袭性肺曲霉菌病患者的病例资料,同时结合相关文献进行复习。结果 5例患者确诊2例,临床诊断3例。痰培养4例查见曲霉菌,2例支气管镜检查病理形态学及特殊染色结果符合曲霉菌感染。影像学表现呈多样性。5例患者均接受伏立康唑治疗,其中2例死亡。结论支气管哮喘患者合并侵袭性肺曲霉菌病临床表现缺乏特异性。早期诊断和尽早抗曲霉菌治疗可降低死亡率。

Objective To enhance the diagnosis and treatment of invasive pulmonary aspergillosis（IPA） in patients with asthma.Methods A retrospective analysis of the clinical features of five pulmonary aspergillosis cases with asthma was performed,and related literatures were reviewed.Results Two of the patients were diagnosised,three cases were clinical diagnosised.Sputum culture of four patients found aspergillus,two cases of pathological bronchoscopy and special staining consistent with aspergillus.Imaging showed the diversity.Voriconazole was indicated as the treatment of choice in all five cases,two patients died.Conclusion Patients of IPA with asthma lack of specific clinical manifestations.Early diagnosis and treatment are critical for reducing the mortality of IPA.