8例变态反应性支气管肺曲霉菌病的临床分析

目的研究变态反应性支气管肺曲霉菌病（ABPA）的的诊断和治疗方法，并总结其临床特点。方法回顾性分析本人在省人民医院进修期间收集8例ABPA患者的临床表现，血清学结果，胸部放射学，病理检查结果，总结其临床特点，结果ABPA的临床表现主要包括哮鸣音、咳嗽、咳痰、咯血、呼吸困难和发热。所有病例血清IgE水平（3040±306）U／mL和外周血嗜酸性粒细胞计数（0．19±0．02）均升高。6例患者曲霉抗原皮肤测试阳性。CT可见中心支气管扩张，支气管壁增厚。、黏液或痰栓、游走性片状、结节状或肿块状肺浸润。所有患者均进行皮质类固醇与抗真菌治疗结合治疗。结论ABPA的临床特征包括哮喘病史，血清总IgE水平升高，曲霉IgE抗体的存在，外周血嗜酸性粒细胞增高，特异性CT表现等。曲霉抗原皮肤测试、血清总IgE水平和胸部CT扫描对ABPA的诊断有重要意义。口服糖皮质激素和抗真菌的药物是有效的治疗方法。

Clinical Analysis of 8 Allergic Bronchopulmonary Aspergillosis

Objeetive To sdudy the diagnostic and treatment methods of allergic bronchopulmonary aspergillosis （ABPA）, and summarizes its clinical features. Methods Retrospective analysis of 8 ABPA patients＇ clinical manifestations, serological results, chest radiology, and pathology results, and summarize the clinical features. Results ABPA clinical manifestations include： wheeze, cough, sputum, hemoptysis, dyspnea, and fever. All cases serum IgE levels （3040±306）U/mL and peripheral blood eosinophilic granulocyte count （0.19±0.02） were increased. Six cases of patients with aspergillus antigen skin test positive. CT visible center of bronchiectasis, bronchial wall thickening. Mucus or sputum, migratory flake, nodular or mass-like pulmonary infiltration. All patients were corticosteroids and antifungal therapy combined treatment. Conclusion The clinical features of ABPA include a history of asthma, elevated total serum IgE, aspergillus IgE antibodies in the presence of eosinophils in peripheral blood increased the specificity of CT findings. Aspergillus antigen skin testing, total serum IgE levels and chest CT scan diagnosis of ABPA. Oral eorticosteroids and antifungal drugs is an effective treatment method.