变应性支气管肺曲霉菌病3例分析

目的 分析变应性支气管肺曲菌病(ABPA)的临床特点,以提高对ABPA的认识,做到早诊断、早治疗.方法 分析3例变应性支气管肺曲霉菌病患者的病历资料,并复习有关支气管肺曲霉菌病的文献资料.结果 3例患者均有咳、痰、喘症状和肺部哮鸣音,其中2例既往有明确的支气管哮喘病史.所有患者均有不同程度的外周血嗜酸性粒细胞升高、血清总IgE升高.3例患者胸部CT影像学表现有肺部渗出性病灶,有中心性支气管扩张征象.肺功能表现为阻塞性通气功能障碍.结论 临床上ABPA极易误诊,若患者有咳喘表现,肺功能示阻塞性通气功能障碍,外周血嗜酸性粒细胞增加,胸片示肺部浸润影呈游走性,有中心性支气管扩张,可进一步查总IgE、烟曲菌特异性IgE、烟曲菌过敏原皮试以确诊.

Clinical Analysis of Three Cases of Allergic Bronchopulmonary Aspergillosis

Objective Analysis of clinical features of allergic bronchopulmonary aspergillosis(ABPA) in order to raise awareness and ensure early diagnosis and treatment.Method analyzed the medical records of three cases of ABPA and reviewed literatures.Result Three cases of patients had cough,sputum,asthma symptoms and lung wheeze.Two cases had a clear history of bronchial asthma.All patients had varying degrees of peripheral blood eosinophil cells and the total serum IgE increased.Three cases of patients with chest CT imaging had Lung exudate and central bronchiectasis signs.Lung function manifested as obstructive ventilatory dysfunction.Conclusion ABPA was misdiagnosed so easily.If the patient has a cough performance,lung function show obstructive ventilatory dysfunction,increased peripheral blood eosinophilic granulocytes,chest radiograph showed pulmonary infiltrates were migratory,central bronchiectasis,further investigations of total IgE,aspergillus fumigatus-specific IgE and aspergillus fumigatus allergen skin test for diagnosis should be done.