北京协和医院77例变应性支气管肺曲菌病住院患者临床特征分析

发布时间：2018-04-22 15:17

本文选题：变应性支气管肺曲菌病 + 临床特征　；参考：《中国医学科学院学报》2017年03期

【摘要】：目的总结变应性支气管肺曲菌病(ABPA)患者的临床特征,增强对ABPA的临床特点认识,以早期诊治。方法回顾性分析了1996年1月至2015年7月北京协和医院住院确诊的77例ABPA患者的临床资料。结果 77例ABPA患者中,男38例,女39例,平均年龄(41.8±18.3)岁。74例(96%)合并支气管哮喘,3例(4%)合并肺囊性纤维化。主要症状有咳嗽(100%)、咳痰(97%)、喘息(86%)、痰栓(25%)、痰中带血(18%)、咯血(9%)、胸痛(9%)、发热(47%)、体重下降(30%)、盗汗(12%)。实验检查主要发现血嗜酸性粒细胞升高(87%)、抗曲菌特异性Ig E升高(89%)、特异性Ig G升高(57%)、曲菌抗原皮试阳性(88%)。肺功能:阻塞性通气功能障碍(66%)、弥散功能障碍(65%)、舒张试验阳性(60%)。胸部CT 72例,中心型支气管扩张(81%)、斑片条索影(79%)、胸膜增厚(49%)、纵隔及肺门多发肿大淋巴结(35%)、结节影(25%)、痰栓征(21%)、游走斑片影(35%)。44例(58%)患者诊断ABPA前误诊为肺结核、肺炎、肺脓肿、肺癌、自身免疫性等疾病。结论 ABPA极易误诊,当支气管哮喘或肺囊性纤维化患者出现喘息、痰栓、血嗜酸性粒细胞增高、中心型支气管扩张、肺内游走斑片影时,应高度警惕合并该病。
[Abstract]:Objective to summarize the clinical features of patients with allergic bronchopulmonary aspergillosis (ABPA) and to enhance the understanding of the clinical characteristics of ABPA for early diagnosis and treatment. Methods the clinical data of 77 patients with ABPA diagnosed in Peking Union Hospital from January 1996 to July 2015 were analyzed retrospectively. Results there were 38 males and 39 females with mean age of 41.8 卤18.3 years (n = 74) with bronchial asthma (n = 3) with pulmonary cystic fibrosis. The main symptoms are cough, cough, sputum, sputum, sputum, sputum suppositories, sputum suppositories, sputum, sputum, sputum, sputum, sputum, sputum, sputum, phlegm, sputum, sputum, sputum, sputum, sputum, sputum, sputum. The results showed that the eosinophils were increased in blood, the specific IgE of Aspergillus was increased 89%, the specific IgG was increased 57%, and the positive rate of Aspergillus antigen skin test was 88%. Pulmonary function: obstructive ventilation dysfunction: 66%, diffuse dysfunction 65%, diastolic test positive. There were 72 cases of chest CT with central bronchiectasis, 81 cases with central bronchiectasis, 79 right with patch, 49 with pleural thickening, 35 with mediastinal and hilar multiple enlarged lymph nodes, 2550 with tuberous shadow, 21 with phlegm embolism and 35 with pulmonary abscess, 44 with pulmonary tuberculosis, pneumonia, and pulmonary abscess before ABPA. Lung cancer, autoimmune diseases, etc. Conclusion ABPA is easy to be misdiagnosed. When asthma or pulmonary cystic fibrosis patients appear wheezing, phlegm thrombus, eosinophil increase, central bronchiectasis, pulmonary wandering spot shadow, we should be on high alert to complicated with the disease.
【作者单位】：中国医学科学院北京协和医学院北京协和医院呼吸内科;
【基金】：国家自然科学基金(81170040、81470229) 国家科技支撑计划(2012BAI05B00)~~
【分类号】：R519

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