论文部分内容阅读
目的提高对变应性支气管肺曲霉病(ABPA)的认识。方法结合文献回顾分析近期我科诊断的1例ABPA的临床表现、实验室检查、影像特点、肺功能变化及治疗情况。结果 ABPA常表现为咳嗽、喘息、气促、咳痰栓、发热等,血嗜酸粒细胞、总Ig E、烟曲霉特异性Ig E升高,典型胸部CT表现包括中心型支气管扩张和游走性浸润影等,给予糖皮质激素联合伊曲康唑治疗临床症状缓解快,肺功能明显改善,但中心型支气管扩张不易恢复。结论 ABPA临床症状不典型,晚期病例具有相对典型影像改变,对“难治性哮喘”等患者早期筛查有助于避免误诊。
Objective To improve the understanding of allergic bronchopulmonary aspergillosis (ABPA). Methods The clinical manifestations, laboratory findings, imaging features, changes of lung function and treatment of 1 case of ABPA diagnosed recently in our department were analyzed retrospectively with literature review. Results ABPA often manifested as cough, wheezing, shortness of breath, expectoration suppository, fever, blood eosinophils, total Ig E, Aspergillus fumigatus specific Ig E increased, typical chest CT manifestations include central bronchiectasis and walk Sexual infiltration shadow, given corticosteroids combined with itraconazole treatment of clinical symptoms, pulmonary function improved significantly, but the central bronchiectasis is not easy to recover. Conclusions The clinical symptoms of ABPA are not typical. The late-stage cases have relatively typical image changes. Early screening of patients with “refractory asthma” can help avoid misdiagnosis.