[哮喘患者的变应性支气管肺曲霉病：一项前瞻性研究的结果]
[Allergic bronchopulmonary aspergillosis in patients with asthma: Results of a prospective study].
作者信息
Kozlova Ya I, Frolova E V, Filippova L V, Uchevatkina A E, Aak O V, Klimko N N
机构信息
I.I. Mechnikov North-Western State Medical University Ministry of Health of Russia, Saint Petersburg, Russia.
出版信息
Ter Arkh. 2017;89(8):13-16. doi: 10.17116/terarkh201789813-16.
AIM
To estimate the frequency of fungal sensitization and the incidence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients.
SUBJECTS AND METHODS
A total of 140 asthmatic patients were examined. They underwent allergologic (skin tests for fungal allergens, estimation of total and fungal allergen-specific IgE levels) and mycological (microscopy and inoculation of respiratory biosubstrates) examinations. Chest computed tomography, when indicated, was done. A group of patients with ABPA and that of patients with severe asthma and fungal sensitization were identified.
RESULTS
The frequency of fungal sensitization in asthmatic patients was 36%; the main allergenic fungi were Aspergillus and Alternaria. The incidence of ABPA was as high as 4% in the patients with asthma and 11% in those with severe asthma and fungal sensitization.
CONCLUSION
The given current diagnostic criteria will assist practitioners to identify ABPA, to prevent its progression, and to initiate specific anti-inflammatory and antifungal therapy in due time.
目的
评估哮喘患者中真菌致敏的频率以及变应性支气管肺曲霉菌病（ABPA）的发病率。
对象与方法
共检查了140例哮喘患者。他们接受了变态反应学检查（真菌变应原皮肤试验、总IgE及真菌变应原特异性IgE水平评估）和真菌学检查（呼吸道生物标本的显微镜检查及接种）。必要时进行胸部计算机断层扫描。确定了一组ABPA患者以及一组重度哮喘合并真菌致敏患者。
结果
哮喘患者中真菌致敏的频率为36%；主要的致敏真菌为曲霉菌和链格孢属真菌。哮喘患者中ABPA的发病率高达4%，重度哮喘合并真菌致敏患者中ABPA的发病率为11%。
结论
现行的诊断标准将有助于临床医生识别ABPA，防止其进展，并及时启动特异性抗炎及抗真菌治疗。
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