Cockrill B A, Hales C A
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, USA.
Annu Rev Med. 1999;50:303-16. doi: 10.1146/annurev.med.50.1.303.
Allergic bronchopulmonary aspergillosis (ABPA) is a syndrome seen in patients with asthma and cystic fibrosis. It is characterized by chronic colonization of the airways with a ubiquitous fungus, Aspergillus fumigatus. The clinical expression of ABPA results from the complex interaction of chronic colonization of the airways with A fumigatus, host factors allowing this colonization, and the host's genetically determined immune response. Clinically the syndrome is characterized by recurrent episodes of wheezing, mucus production, pulmonary infiltrates, and elevated levels of serum IgE. Many patients develop central bronchiectasis, and a subset will go on to endstage fibrotic lung disease. It is thought that treatment will prevent this progression. The mainstay of therapy remains oral corticosteroids.
变应性支气管肺曲霉病(ABPA)是一种在哮喘和囊性纤维化患者中出现的综合征。其特征是气道被一种普遍存在的真菌——烟曲霉长期定植。ABPA的临床表型源于气道被烟曲霉长期定植、允许这种定植的宿主因素以及宿主基因决定的免疫反应之间的复杂相互作用。临床上,该综合征的特征为喘息反复发作、黏液产生、肺部浸润以及血清IgE水平升高。许多患者会发展为中心性支气管扩张,一部分患者会进而发展为终末期纤维化肺病。人们认为治疗可预防这种进展。治疗的主要手段仍然是口服糖皮质激素。