变态反应性支气管肺曲霉病研究进展

Advance in research of allergic bronchopulmonary aspergillosis

变态反应性支气管肺曲霉病(ABPA)以曲霉诱发变态反应为主要特征,最常见致病菌为烟曲霉,通常发生在哮喘或囊性纤维化的患者中。ABPA临床特点包括哮喘的急性发作,血清嗜酸性粒细胞、总Ig E水平升高,影像学表现为肺浸润、支气管扩张等。早期识别运用糖皮质激素治疗有效,但有可能需要长期服用激素控制,现在越来越多的证据支持抗真菌药物治疗ABPA。本文就其发病机制、临床表现、实验室辅助检查、诊断、分期和治疗作一简述。

Allergic bronchopulmonary aspergillosis（ABPA） is an immunologically mediated lung disease caused by the Aspergillus, mostly due to a fumigatus. ABPA is predominantly a disease of patients with asthma or cystic fibrosis. Clinical characteristics of ABPA include active asthma, an elevated serum eosinophilia and total Ig E level,and fleeting pulmonary parenchymal opacities, bronchiectasis. Early recognition allows treatment with corticosteroids,which are effective but may be required indefinitely. Currently, more and more evidence support the role of antifungal drugs in the treatment with ABPA. This article reviews the current development of the pathogenesis, clinical manifestations, laboratory examinations, diagnosis, staging and treatment of ABPA.