16例ABPA临床特征及误诊分析

Analysis of clinical features and misdiagnose of 16 patients with ABPA

目的总结变应性支气管肺曲霉病(ABPA)临床特征,提高对本病的认识。方法回顾性总结ABPA的临床特征,对误诊原因进行分析。结果共收集病例16例,男10例,女6例;外周血嗜酸粒细胞及总IgE不同程度升高,部分GM及G试验升高,肺功能不同程度异常。CT最常见为中心型支气管扩张,斑片渗出影,条状影,结节影,实变影等;痰、BALF培养及穿刺组织病理示曲霉3例。16例患者最初诊断误诊率达100%,明确诊断距发病时间为(2-25)年,平均13±2年。结论 ABPA起病隐匿、临床特征不典型,极易误诊。对高危人群,尽早行ABPA相关检查协助诊断以进一步明确诊断。

Objective To summarize the clinical features of allergic bronchopulmonary aspergillosis （ABPA） in order to improve the recognition of ABPA. Methods The clinical data of 16 patients with ABPA were retrospectively analyzed to summarize the causes of misdiagnosis. Results 10 cases were male, and the rest 6 cases were female. The peripheral blood eosinopbil cells （PBEC） and total IgE （T-IgE） increased at to a certain level in all patients, and the test of GM and G increased in some patients. Their pulmonary function showed a different degree of disorder. The most common CT images included central bronchiectasis, patchy consolidation, lobar, and con- solidation shadows. 16 patients were all initially misdiagnosed, and the duration to confirm their disease was 2 to 25 years, with an average of 13 ＋ 2 years. Conclusion The clinical features of ABPA are not typical, so it is easily misdiagnosed.