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目的 :提高临床医生对变应性支气管肺曲霉病(allergic bronchopulmonaryaspergillosis,ABPA)合并侵袭性肺曲霉病(invasive aspergillosis,IPA)的认识。方法 :收集2014年1月至2015年1月东南大学附属中大医院收治的2例变应性支气管肺曲霉病合并侵袭性肺曲霉病患者的临床特点,以“侵袭性肺曲霉病”及“变应性支气管肺曲霉病”组合为检索词,未设定时间限制,通过万方数据库检索到1篇中文文献;以“invasive pulmonary aspergillosis”及“allergic bronchopulmonaryaspergillosis”组合为检索词,未设定时间限制,在Pubmed,Cochrane Library及Web of Science数据库检索到2篇英文文献,均为个案报道。结合文献报道的3例变应性支气管肺曲霉病合并侵袭性肺曲霉病患者的临床表现,实验室检查,影像资料进行分析。结果:5例IPA合并ABPA患者中,5例均为确诊病例,本文中例1和例2患者均明显好转,其他3例患者均治疗无效而死亡。结论:ABPA合并IPA在临床中较少见,其病情相对复杂和严重,需尽早采取敏感的抗真菌药物及激素的综合治疗。
Objective: To improve the understanding of clinicians on allergic bronchopulmonary aspergillosis (ABPA) with invasive aspergillosis (IPA). Methods: The clinical features of 2 patients with allergic bronchopulmonary aspergillosis complicated with invasive pulmonary aspergillosis admitted to the Affiliated Zhongda Hospital affiliated to Southeast University from January 2014 to January 2015 were collected. The patients with invasive pulmonary aspergillosis And “Allergic bronchopulmonary aspergillosis” as a search term, no time limit was set, one Chinese document was retrieved through Wanfang database; the combination of “” “invasive pulmonary aspergillosis” and “allergic bronchopulmonary aspergillosis” As a search term, no time limit was set, and two English articles were found in Pubmed, Cochrane Library and Web of Science databases. The clinical manifestations, laboratory tests and imaging data of 3 patients with allergic bronchopulmonary aspergillosis complicated with invasive pulmonary aspergillosis were reported in this paper. Results: Of the 5 cases of IPA with ABPA, 5 cases were confirmed cases. In this paper, cases 1 and 2 were significantly improved, and the other 3 cases died of ineffective treatment. Conclusion: ABPA combined with IPA is rare in clinical practice. Its condition is relatively complicated and serious. It is necessary to take sensitive antifungal agents and hormones as soon as possible.