变态反应性支气管肺曲霉菌病误诊23例分析

目的 总结变态反应性支气管肺曲霉菌病(allergic bronchopulmonary aspergillosis,ABPA)的诊治经验及误诊原因.方法 回顾性分析1985至2008年诊断的23例ABPA的临床资料,总结ABPA的诊治经验及误诊原因.结果 本组23例中22例48次被误诊.主要被误诊肺结核、支气管哮喘、肺部感染、嗜酸细胞性肺炎、肺癌等,误诊时程在30个(14,114)月.结论 临床医师对本病的认识不足是误诊的主要原因,提高对本病的认识程度,尽早行过敏原筛查,熟悉其影像学特征是减少误诊的关键.

Misdiagnosis of allergic bronchopulmonary aspergillosis

Objective To summarize the experience in diagnosis of allergic bronchopulmonary aspergillosis(ABPA) and to analyze the causes of misdiagnosis. Methods Clinical data from 23 patients treated from 1985 to 2008 were analyzed retrospectively, and the causes of misdiagnosis were reviewed.Results Of all 23 cases,22 cases (95.7%) were misdiagnosed. They were misdiagnosed by pulmonary tuberculosis,bronchial asthma, pulmonary infection, eosinophilic pneumonia and lung cancer. Conclusions Lack of knowledge to pulmonary aspergilloma results in misdiagnosis. It could be avoided by improving awareness of ABPA, making allergen analysis of ABPA as early as possible and mastering the typical imaging.