Sehgal I S, Agarwal R
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
J Postgrad Med. 2014 Jan-Mar;60(1):41-5. doi: 10.4103/0022-3859.128806.
Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder caused by immune reactions mounted against the ubiquitous fungus Aspergillus fumigatus. The disease clinically manifests with poorly controlled asthma, hemoptysis, systemic manifestations like fever, anorexia and weight loss, fleeting pulmonary opacities and bronchiectasis. The natural course of the disease is characterized by repeated episodes of exacerbations. Almost 30-40% of the patients require prolonged therapy, which currently consists of corticosteroids and anti-fungal azoles; both these agents have significant adverse reactions. Amphotericin B administered via the inhaled route can achieve a high concentration in the small airways with minimal systemic side-effects. Nebulized amphotericin B has been used in the management of invasive pulmonary aspergillosis. The aim of this review is to study the utility of inhaled amphotericin in ABPA.
变应性支气管肺曲霉病（ABPA）是一种免疫性肺部疾病，由针对普遍存在的烟曲霉的免疫反应引起。该疾病临床上表现为哮喘控制不佳、咯血、发热、厌食和体重减轻等全身症状、短暂性肺部混浊和支气管扩张。疾病的自然病程以反复发作为特征。近30%-40%的患者需要长期治疗，目前的治疗方法包括使用皮质类固醇和抗真菌唑类药物；这两种药物都有明显的不良反应。经吸入途径给药的两性霉素B可在小气道中达到高浓度，且全身副作用最小。雾化两性霉素B已用于侵袭性肺曲霉病的治疗。本综述的目的是研究吸入两性霉素在ABPA中的应用价值。
