变态反应性支气管肺曲霉病诊治的研究进展

Advance in diagnosis and treatment of allergic bronchopuimonary aspergillosis

变态反应性支气管肺曲霉病（allergic bronchopulmonary aspergillosis，ABPA）与烟曲菌感染引起的变态反应相关。ABPA可引起血清总IgE升高，外周血嗜酸粒细胞升高，肺浸润和中心性支气管扩张。若未得到有效治疗可发生肺组织结构的不可逆破坏，最终导致呼吸衰竭，故ABPA的早期诊断和早期治疗十分重要。ABPA的治疗取决于疾病的分期、临床表现、血清总IgE、肺功能和影像学检查，以往多以口服糖皮质激素治疗为主，目前普遍推荐口服糖皮质激素加抗真菌的联合治疗方案，以达到控制机体对烟曲菌抗原的过敏反应，清除寄生于气道内的烟曲菌的目的。本文将对近年ABPA诊治进展作一综述。

Allergic bronchopulmonary aspergillosis （ABPA） is a disease that results from a sensitization to fungus aspergiltus fumigatus. It is characterized by elevated serum total IgE level and peripheral eosinophilia, pulmonary infiltrates and central bronchiectasis. The lung tissue can be damaged irreversibly without effective treatment resulting in respiratory falure, so early diagnosis and treatment is of great importance. The treatment of ABPA depends on the stage of the disease, clinical characteristics, serum lgE level, pulmonary function and chest radiology. Previously, corticosteroid was used as a first choice, but now the combination of corticosteroid and antifungal drugs is more recommended for the purpose of controlling sensitization to fungus aspergillus fumigatus and clearing aspergillus fumigatus in airway. This article reviews the current development of diagnosis and treatment of ABPA.