过敏性支气管肺曲霉菌病发病机制、诊断及辅助检查的研究进展

Research Progress on Pathogenesis,Diagnosis and Supplementary Examinations of Allergic Bronchopulmonary Aspergillosis

过敏性支气管肺曲霉菌病(ABPA)为支气管哮喘常见合并症,其致病菌为曲霉菌,近年其全球发病率呈上升趋势。本文结合既往文献针对ABPA的发病机制、诊断及辅助检查进行综述,结果发现ABPA发病机制主要与遗传因素、免疫缺陷有关;其临床表现与呼吸系统疾病相似,容易混淆,临床误诊率较高;Rosenberg标准、Greenberger标准、ISHAM标准2013版、ISHAM标准2016版及Asano标准是ABPA的诊断标准,但各诊断标准并不统一;ABPA的实验室检查以烟曲霉菌特异性IgE和IgG检查为主,影像学检查首选高分辨率CT。

Allergic bronchopulmonary aspergillosis(ABPA)is a common complication of bronchial asthma.Its pathogen is aspergillus,and the incidence of global is increasing in recent years.This article reviews the pathogenesis,diagnosis and auxiliary examination of ABPA in combination with previous literature,and finds that the pathogenesis of ABPA is mainly related to genetic factors and immunodeficiency.Its clinical manifestations overlap with respiratory diseases and it is easy to be confused,leading to a highe misdiagnosis of clinical practice.Rosenberg criteria,Greenberg criteria,ISHAM criteria 2013 version,ISHAM criteria 2016 version and Asano criteria are the diagnostic criteria of ABPA,but the diagnostic criteria are not unification.Laboratory examinations are mainly based on aspergillus fumigatus-specific IgE and IgG examinations.High resolution CT is the first choice for imaging examination.