Cai R J, Feng J T
Department of Respiratory and Critical Care, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Dec 12;47(12):1176-1180. doi: 10.3760/cma.j.cn112147-20240710-00400.
Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease characterized by sensitization to . Patients often present with recurrent wheezing, fleeting pulmonary infiltrates, and bronchiectasis. Due to the atypical clinical manifestations, unclear pathogenesis, and lack of unified diagnostic criteria, ABPA is often misdiagnosed or overlooked. In 1977, Rosenberg criteria were introduced as the first diagnostic criteria for ABPA, but without further elaboration on the weighting of diagnostic items and thresholds. In 2013, the International Society for Human and Animal Mycology (ISHAM) proposed more specific diagnostic criteria. As the understanding of fungal sensitization disease has progressed, the concept of allergic bronchopulmonary mycosis (ABPM) has been proposed and has received increasing attention. In 2021, Asano proposed the ABPM diagnostic criteria and found that their diagnostic sensitivity was superior to that of Rosenberg and ISHAM criteria. In 2024, ISHAM again revised the ABPA diagnostic criteria and proposed diagnostic criteria for ABPM. This article provided an analysis and interpretation of the diagnostic criteria for ABPA/ABPM in order to help the diagnosis and treatment of this disease.
变应性支气管肺曲霉病（ABPA）是一种以对……致敏为特征的肺部疾病。患者常表现为反复发作的喘息、短暂的肺部浸润和支气管扩张。由于临床表现不典型、发病机制不明且缺乏统一的诊断标准，ABPA常被误诊或漏诊。1977年，罗森伯格标准作为ABPA的首个诊断标准被提出，但未对诊断项目的权重和阈值作进一步阐述。2013年，国际人类和动物真菌学会（ISHAM）提出了更具体的诊断标准。随着对真菌致敏疾病认识的进展，变应性支气管肺真菌病（ABPM）的概念被提出并受到越来越多的关注。2021年，浅野提出了ABPM诊断标准，并发现其诊断敏感性优于罗森伯格标准和ISHAM标准。2024年，ISHAM再次修订了ABPA诊断标准，并提出了ABPM诊断标准。本文对ABPA/ABPM的诊断标准进行了分析和解读，以帮助该病的诊断和治疗。
