Manchester Academic Health Science Centre, Manchester, UK.
Eur Respir J. 2013 Mar;41(3):621-6. doi: 10.1183/09031936.00226911. Epub 2012 Jun 27.
Chronic pulmonary aspergillosis (CPA) may complicate pulmonary sarcoidosis. We re-estimated the global burden of sarcoidosis and the burden of CPA complicating sarcoidosis. We searched the literature and reference lists of retrieved papers to identify all published sarcoidosis incidence and prevalence data. We estimated the frequency of CPA from 11 papers relating to >3,000 patients with sarcoidosis to derive CPA patient numbers. We applied an annual attrition rate of 15% (range 10-25%) to estimate the global burden of CPA. We estimate that the annual incidence of sarcoidosis is 344,000 patients worldwide and the prevalence is ∼1,238,000 cases, distributed as follows: 165,979 in Europe, 224,000 in the Americas, 492,892 in Africa, 80,023 in the Eastern Mediterranean, 41,660 in the West Pacific and 234,010 in Southeast Asia. CPA complicates sarcoidosis in 3-12% of cases. Using a 6% frequency, we estimate a global burden of 71,907 (range 35,954-143,815 (3-12%)) CPA cases complicating sarcoidosis, with 24% and 37% of cases estimated to be present in the Americas and Africa, because of the higher incidence of sarcoidosis in black people. As CPA responds to long-term antifungal therapy, which may prevent life-threatening haemoptysis, screening periodically for CPA in those with pulmonary sarcoidosis may be important, especially in patients requiring corticosteroid therapy.
慢性肺曲霉病（CPA）可能使结节病复杂化。我们重新估算了结节病的全球负担以及结节病并发 CPA 的负担。我们检索了文献和检索到的论文参考文献，以确定所有已发表的结节病发病率和患病率数据。我们从 11 篇涉及 3000 多名结节病患者的论文中估算了 CPA 的频率，以得出 CPA 患者人数。我们应用每年 15%（范围为 10%-25%）的衰减率来估算全球 CPA 负担。我们估计，全世界每年结节病的发病率为 344000 例，患病率约为 1238000 例，分布如下：欧洲 165979 例，美洲 224000 例，非洲 492892 例，东地中海 80023 例，西太平洋 41660 例，东南亚 234010 例。CPA 在结节病患者中的发病率为 3%-12%。我们假设发病率为 6%，估算出全世界有 71907 例（范围为 35954-143815 例（3%-12%））结节病并发 CPA，其中 24%和 37%的病例估计出现在美洲和非洲，这是因为黑种人结节病发病率较高。由于 CPA 对长期抗真菌治疗有反应，可能预防威胁生命的咯血，因此定期对有肺部结节病的患者进行 CPA 筛查可能很重要，特别是对需要皮质类固醇治疗的患者。
