侵袭性肺曲霉病实验室诊断现状

The status quo on laboratory diagnosis of invasive pulmonary aspergillosis

目前,随着免疫受损人群的逐渐上升,侵袭性肺曲霉病(IPA)已日渐成为严重免疫受损者,如接受器官移植、皮质类固醇激素的长期应用、肿瘤化疗或患有慢性粒细胞减少症、白血病、HIV感染及其他急危重病的患者死亡的主要肺部感染性疾病之一。而IPA的确诊需综合考虑患者临床表现、免疫状态、职业史等及各项实验诊断方法检测等。由于传统检查手段的局限性使IPA诊断困难,容易漏诊误诊,导致治疗不及时或过度治疗,增加了IPA的病死率。因此早期快速、准确诊断是治疗IPA的关键,为此,该文综述近年来国内外文献资料关于IPA早期诊断的相关研究成果,为提高临床诊断IPA感染的水平提供一定的参考。

Currently,with gradual increase of immunocompromised population, invasive pulmonary aspergil-losis（ IPA） has become one of the main pulmonary infectious diseases resulting in the death of severe immunocompro-mised patients, such as patients who received organ transplants, long-term use of corticosteroid hormone or chemo-therapy for cancers, or suffered from chronic granulocytopenia, leukemia, HIV infection, or other critical diseases. However, IPA infection needs to consider several factors synthetically, including clinical manifestation, immune state, occupational history and so on, and use many kinds of laboratory diagnosis methods to confirm the diagnosis. The limitation of traditional examination method makes the diagnosis of IPA more difficult and easily misdiagnosis, wrong therapy, which lead to delayed treatment or overtreatment, increasing of fatality rate of IPA, so it is vital to di-agnose IPA quickly and accurately in early stage.In summary, the thesis gathers many documents at home and a-broad about research achievements of IPA in early diagnosis, in order to provide a reference for improving the level of IPA clinical diagnosis.