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治疗变应性支气管肺曲霉病:综述

Treating Allergic Bronchopulmonary Aspergillosis: A Review.

作者信息

Patel Avani R, Patel Amar R, Singh Shivank, Singh Shantanu, Khawaja Imran

机构信息

Internal Medicine, Northern California Kaiser Permanente, Fremont, USA.

Internal Medicine, Southern Medical University, Guangzhou, CHN.

出版信息

Cureus. 2019 Apr 24;11(4):e4538. doi: 10.7759/cureus.4538.

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder that results from a hypersensitivity reaction to the fungi Aspergillus fumigatus (Af). It presents with pulmonary infiltrates and bronchiectasis. Past research studies on ABPA have led to the conclusion that it is both underdiagnosed and much more prevalent than previously assumed. The underdiagnosing of ABPA is due to a lack of consensus regarding diagnosis and treatment. Complications that result from delay in treatment for ABPA are pulmonary fibrosis, bronchiectasis with chronic sputum production, and severe persistent asthma with loss of lung function. Because of this, it becomes imperative that ABPA treatment guidelines are reviewed and more thoroughly evaluated regarding their efficacy. The following article addresses the epidemiology, the pathophysiology, and the treatment of ABPA. The treatment is studied in detail regarding the types of medications used and their proven clinical impact on patients according to past research studies. The aim of this article is to address the current need for larger clinical trials in order to learn more and establish more formal treatment protocols for ABPA.

摘要

变应性支气管肺曲霉病(ABPA)是一种肺部疾病,由对烟曲霉(Af)的超敏反应引起。它表现为肺部浸润和支气管扩张。过去关于ABPA的研究得出结论,该病既存在诊断不足的情况,而且其患病率比之前认为的要高得多。ABPA诊断不足是由于在诊断和治疗方面缺乏共识。ABPA治疗延误导致的并发症包括肺纤维化、伴有慢性咳痰的支气管扩张以及伴有肺功能丧失的严重持续性哮喘。因此,审查ABPA治疗指南并对其疗效进行更全面的评估变得势在必行。以下文章论述了ABPA的流行病学、病理生理学和治疗方法。根据过去的研究,对所用药物类型及其对患者已证实的临床影响进行了详细研究。本文的目的是满足当前开展更大规模临床试验的需求,以便更多地了解ABPA并建立更正式的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f8b/6592456/6b3e710696e2/cureus-0011-00000004538-i01.jpg

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