变态反应性支气管肺曲霉病的诊断与治疗

变态反应性支气管肺曲霉病是哮喘和囊性纤维化患者常见的并发症，由机体对曲霉的变态反应引起，表现为喘息、肺部浸润、支气管扩张和肺纤维化；病理改变包括黏液嵌塞、中心性支气管肉芽肿、嗜酸细胞肺炎和慢性或渗出性毛细支气管炎；诊断依靠临床表现、实验室以及影像学改变等标准，并分为囊性纤维化和非囊性纤维化两组；治疗主要是口服激素联合依曲康唑。

Diagnosis and treatment of allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis(ABPA) occurs as a complication of bronchial asthma or cystic fibrosis(CF).It is a hypersensitivity lung disease clinically characterized by manifestation of wheezing, pulmonary infiltrates,bronchiectasis and fibrosis.The pathophysiologic mechanisms are mediated by a first and direct interaction of Aspergillus fumigatus antigens with airway epithelial cells. Its pathologic manifesitions include mucoid impaction of bronchi, bronchocentric granulomatosis, eosinophilic pneumonia and chronic or exudative bronchiolitis.The diagnosis is based upon a combination of clinical,laboratory,and radiographic criteria,occasional patients require pathologic diagnosis. Because several of the criteria used for ABPA diagnosis are common manifestations of cystic fibrosis ,here we put the diagnosis into two parts (ABPA with CF and ABPA without CF).Itraconazole is now recommended for combination with hormones in the treatment.