最早报道的少数变应性肺炎(HP)病例是在20世纪初,见于接触发霉的干草或稻草的农民。随后,将HP归之于见于许多环境中的多种吸入性抗原所致。HP是过度免疫反应产生的结果,能引起急性感染样症状或产生进行性甚至不可逆性肺损伤。HP的诊断主要依赖于其临床综合特征。最近已发表了HP的临床诊断标准。引起HP的免疫机制仍未完全了解,最初认为,这是一种Ⅲ型和Ⅳ型免疫反应,而目前已更清楚地了解到这是涉及到一些复杂机制的炎症事件,这些事件包括促炎细胞因子的释放及经表面活性剂、树突状细胞和T调节细胞的免疫控制机制的降低。尽管对HP的认识不断提高,但对其治疗和预后仍无改善。口服糖皮质激素仍然是唯一有效药物,而避免接触变应原是最佳预防方法。如果HP发生后未能得到明确诊断,则可引起不可逆性肺损伤,表现为肺纤维化或肺气肿,导致呼吸功能不全,甚至死亡。 The earliest reported minority cases of allergic pneumonia (HP) were found in early twentieth century farmers exposed to moldy hay or straw. Subsequently, HP was attributed to a variety of inhaled antigens found in many environments. HP is the result of an excessive immune response that can cause acute infection-like symptoms or produce progressive or even irreversible lung injury. HP’s diagnosis depends mainly on its clinical features. The clinical diagnostic criteria for HP have been published recently. The immune mechanism that causes HP is still not completely understood. Initially, it was thought to be a type III and IV immune response. It has now become clearer that this is an inflammatory event involving some complex mechanisms, including proinflammatory cells Factor release and reduction of immune control mechanisms by surfactants, dendritic cells and T-regulatory cells. Despite rising awareness of HP, there is still no improvement in its treatment and prognosis. Oral glucocorticoid remains the only potent drug, and avoiding exposure to allergens is the best way to prevent it. Failure to develop a definitive diagnosis after HP can cause irreversible lung injury, manifested as pulmonary fibrosis or emphysema, resulting in respiratory insufficiency and even death.