78例变应性支气管肺曲霉病住院患者临床特征分析

Clinical characteristics of 78 inpatients with allergic bronchopulmonary aspergillosis

目的分析变应性支气管肺曲霉病(ABPA)住院患者的临床特征。方法抽取2016年9月至2018年9月郑州大学第一附属医院收治的ABPA住院患者78例,回顾性分析其临床资料,总结ABPA的临床特征。结果78例ABPA患者中男38例,女40例,年龄(45.23±13.84)岁。其中合并慢性阻塞性肺疾病10例,合并支气管哮喘10例,合并支气管扩张10例,合并过敏性鼻炎1例;从出现症状到确诊时间为1个月~40年,主要症状有咳嗽(78例)、咳痰(73例)、痰中带血(11例)、喘息伴有胸闷(52例)、咯血(8例)、胸痛(2例)、发热(22例)、盗汗(6例)、乏力(7例)。肺功能检查见阻塞性通气功能障碍11例,重度混合性通气功能障碍3例,支气管舒张试验阳性22例,支气管激发试验阳性22例。胸部CT影像见斑片条索影65例,中心型支气管扩张46例,胸膜增厚6例,纵隔淋巴结肿大22例,纵隔、肺门结节影17例,痰栓征2例。结论ABPA临床表现为慢性哮喘和支气管扩张,从出现症状到确诊时间较长,临床症状缺乏特异性,胸部影像学表现多样。

Objective To analyze the clinical characteristics of inpatients with allergic bronchopulmonary aspergillosis(ABPA).Methods A total of 78 ABPA inpatients admitted to the First Affiliated Hospital of Zhengzhou University from September 2016 to September 2018 were selected,their clinical data were retrospectively analyzed and the clinical characteristics of ABPA were summarized.Results Among the 78 ABPA patients,38 were males and 40 were females,aged(45.23±13.84)years old.Among them,there were 10 cases with chronic obstructive pulmonary disease,10 cases with bronchial asthma,10 cases with bronchiectasis,and 1 case with allergic rhinitis;the time from symptom onset to diagnosis of ABPA was 1 month to 40 years,the main symptoms were cough(78 cases),expectoration(73 cases),bloody sputum(11 cases),wheezing with chest tightness(52 cases),hemoptysis(8 cases),chest pain(2 cases),fever(22 cases),night sweats(6 cases),fatigue(7 cases).Pulmonary function examination showed 11 cases of obstructive ventilatory dysfunction,3 cases of severe mixed ventilatory dysfunction,22 cases of positive broncho dilation test,and 22 cases of positive bronchial provocation test.The chest CT scan images showed 65 cases of patch striation,46 cases of central bronchiectasis,6 cases of pleural thickening,22 cases of mediastinal lymphadenopathy,17 cases of mediastinal and hilar nodules,and 2 cases of thrombotic phlegm.Conclusions The clinical manifestations of ABPA are chronic asthma and bronchiectasis.It takes a long time from appearance to diagnosis of ABPA,.The clinical symptoms lack specificity and the chest imaging manifestations are diverse.