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雾化两性霉素治疗变应性支气管肺曲霉病。

Aerosolized amphotericin for the treatment of allergic bronchopulmonary aspergillosis.

机构信息

Department of Pediatrics, University of Kentucky College of Medicine, C424 University of Kentucky Medical Center, Lexington, KY, USA.

出版信息

Pediatr Pulmonol. 2010 Nov;45(11):1145-8. doi: 10.1002/ppul.21300.

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus fumigatus that occur frequently in patients with cystic fibrosis (CF). Recurrent episodes of bronchial obstruction, inflammation, and mucoid impaction occur in ABPA and results in bronchiectasis, fibrosis, and respiratory failure. The treatment of ABPA includes corticosteroids to reduce the acute inflammation and intraconazole to reduce the fungal colonization load in order to reduce lung injury. This case discusses the successful use of aerosolized amphotericin B for the treatment of ABPA in a 14-year-old patient with CF listed for lung transplant. The patient required fewer hospitalizations, and both oral corticosteroids and anti-fungal therapy were eventually stopped.

摘要

变应性支气管肺曲霉病(ABPA)是一种对烟曲霉的复杂超敏反应,常发生于囊性纤维化(CF)患者中。ABPA 会反复出现支气管阻塞、炎症和黏液嵌塞,导致支气管扩张、纤维化和呼吸衰竭。ABPA 的治疗包括使用皮质类固醇以减轻急性炎症,以及使用伊曲康唑以减少真菌定植负荷,从而减轻肺损伤。本病例讨论了在一名拟行肺移植的 CF 患者中,成功使用雾化两性霉素 B 治疗 ABPA 的情况。该患者需要住院的次数更少,并且最终停用了口服皮质类固醇和抗真菌治疗。

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