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目的总结变应性支气管肺曲霉病(ABPA)病例的临床表现及诊疗方法,为早期诊断及治疗提供依据。方法收集淮安市第一人民医院2012至2015年确诊的ABPA病例作为研究对象,对病例的临床表现、实验室、影像学检查及治疗方法等资料进行分析。结果共确诊ABPA患者10例,均有咳嗽,其中7例有气喘,所有患者的外周血嗜酸粒细胞及Ig E水平均明显升高。肺功能检查提示其中8例表现为轻到重度的阻塞性或混合性通气功能障碍。胸部CT示10例患者均有中心性支气管扩张,其中9例伴实质浸润。确诊后10例患者均给予抗真菌及全身糖皮质激素治疗,治疗后患者的咳嗽、气喘症状均有缓解。结论 ABPA的临床表现缺乏特异性,但可根据血清Ig E水平、外周血嗜酸粒细胞计数、胸部CT等进行确诊,且抗真菌及全身糖皮质激素对该病的疗效尚可。
Objective To summarize the clinical manifestations and diagnosis and treatment of allergic bronchopulmonary aspergillosis (ABPA) and provide the basis for early diagnosis and treatment. Methods The ABPA cases diagnosed in First People’s Hospital of Huai’an from 2012 to 2015 were collected as the research object, and the clinical manifestations, laboratory, imaging examination and treatment methods were analyzed. Results A total of 10 ABPA patients were diagnosed with cough, of which 7 had asthma. The levels of peripheral blood eosinophils and IgE were significantly increased in all patients. Pulmonary function tests revealed that eight of them showed mild to severe obstructive or mixed ventilatory dysfunction. Chest CT showed 10 patients had central bronchiectasis, including 9 cases with substantial infiltration. After the diagnosis of 10 patients were given anti-fungal and systemic glucocorticoid treatment, the patient’s cough, asthma symptoms were relieved. Conclusions The clinical manifestations of ABPA are not specific, but they can be diagnosed on the basis of serum IgE level, peripheral blood eosinophil count and chest CT. Antifungal and systemic glucocorticoids are effective in treating this disease.