摘要目的 探讨变应性支气管肺曲霉病(ABPA)的临床与影像学特点,提高早期诊断率.方法 通过中国生物医学文献光盘数据库(CBM-Disk)检索1991年1月至2008年3月有关报道ABPA的文献,剔除重复累计报道病例,结合本院收治的3例患者,回顾性分析我国ABPA的临床资料.结果 57例ABPA中,男33例,女24例,平均年龄(41±15)岁.主要临床表现:咳嗽51例,咳痰50例,喘息47例,气促44例,发热33例,咯血28例,咳痰栓史18例,胸痛13例,消瘦8例.外周血嗜酸粒细胞绝对值为(0.01～15.34)×10<'9>/L,中位值为2.46×10<'9>/L.外周血总IgE为349～13 000IU/ml.41例行肺功能检查,FEV<,1>%为(64±25)%,FEV<,1>/FVC%为(63±11)%.9例支气管舒张试验阳性,3例组胺激发试验阴性.33例行胸部高分辨率(HR)CT检查,斑片状渗出影32例,中心性支气管扩张25例,树杈样或条状影12例,结节影11例,实变影8例,纵隔淋巴结增大13例,病变游走24例.结论 我国ABPA少见,临床症状无特异性.对可疑患者应及早行外周血嗜酸细胞计数、血清IgE检测、曲霉皮肤试验及纤维支气管镜等检查.

abstractsObjective To describe the clinical features and diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Methods Three cases of ABPA from this hospital were presented. Chinese Biomedical Disk (CBM-Disk) was searched to identify Chinese ABPA cases from 1991 to 2008, and a retrospective analysis of all the cases was made. Results Fifty-seven cases of ABPA were collected, including 33 male and 24 female patients,with a mean age of (41±15)yrs. The main clinical manifestations included cough (n=51), expectoration (n=50) , wheeze (n=47) , dyspnea (n=44) , fever (n=33), hemoptysis(n=28), sputum plugs (n=18) , chest pain (n=13) and weight loss (n=8). Forced expired volume in one second (FEV<,1>) was (64±25)% predicted, and FEV<,1>/forced vital capacity (FVC) was (63±11)%. Chest CT was performed in 33 cases. Patchy infiltration was present in 32, central bronchiectasis in 25, mueoid impaction (glover-finger/band linear opacities ) in 12, nodular opacities in 11, consolidation in 8 and mediastinal adenopathy in 13 cases, while 24 cases presented fleeting infiltrations. Conclusion ABPA is a rare disease. Measurement of total IgE,A. fumigatus-specific IgE, and immediate cutaneous reaction to A. fumigatus are help for confirmation of the diagnosis.