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变应性支气管肺曲霉病合并支气管扩张的临床特征及危险因素分析

Clinical characteristics and risk factors analysis of allergic bronchopulmonary aspergillosis combined with bronchiectasis.

作者信息

He Qian, Li Min, Cao Jiaqi, Zhang Ming, Feng Chunlai

机构信息

Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Soochow University, Changzhou, China.

Department of Respiratory and Critical Care Medicine, Xishan People's Hospital of Wuxi City, Wuxi, China.

出版信息

Front Med (Lausanne). 2025 May 23;12:1557241. doi: 10.3389/fmed.2025.1557241. eCollection 2025.

Abstract

BACKGROUND

Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder caused by a hypersensitivity reaction to colonizing the airways. Research on the clinical characteristics and risk factors of ABPA in patients with bronchiectasis is limited. This study aimed to investigate the clinical features and risk factors of ABPA in patients with bronchiectasis to improve clinical recognition.

METHODS

We retrospectively collected clinical data from bronchiectasis patients hospitalized at the Third Affiliated Hospital of Soochow University between September 2017 and December 2021.

RESULTS

A total of 251 patients were included in the analysis, of which 46 were confirmed to have ABPA with bronchiectasis. The remaining 205 patients served as control group. There were no significant differences in clinical symptoms (fever, cough, hemoptysis, chest pain, wheezing) between the two groups. However, blood eosinophil count and total IgE levels were significantly higher in the ABPA group compared to the control group. Both univariate and multivariable analyses revealed that a higher bronchiectasis severity index (BIS), frequent pet contact, hypoproteinemia, and colonization significantly increased the risk of developing ABPA in bronchiectasis.

CONCLUSION

The clinical symptoms of ABPA in patients with bronchiectasis are clinically indistinguishable from those of non-ABPA bronchiectasis A higher BIS, frequent pet contact, hypoproteinemia, and colonization are identified as key risk factors for ABPA development in bronchiectasis.

摘要

背景

变应性支气管肺曲霉病(ABPA)是一种由气道定植超敏反应引起的复杂肺部疾病。支气管扩张症患者中ABPA的临床特征和危险因素的研究有限。本研究旨在调查支气管扩张症患者中ABPA的临床特征和危险因素,以提高临床识别能力。

方法

我们回顾性收集了2017年9月至2021年12月在苏州大学附属第三医院住院的支气管扩张症患者的临床资料。

结果

共有251例患者纳入分析,其中46例确诊为支气管扩张症合并ABPA。其余205例患者作为对照组。两组患者的临床症状(发热、咳嗽、咯血、胸痛、喘息)无显著差异。然而,ABPA组的血嗜酸性粒细胞计数和总IgE水平显著高于对照组。单因素和多因素分析均显示,较高的支气管扩张严重程度指数(BIS)、频繁接触宠物、低蛋白血症和曲霉菌定植显著增加了支气管扩张症患者发生ABPA的风险。

结论

支气管扩张症患者中ABPA的临床症状在临床上与非ABPA支气管扩张症难以区分。较高的BIS、频繁接触宠物、低蛋白血症和曲霉菌定植被确定为支气管扩张症患者发生ABPA的关键危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b98/12140996/a99bc6dc1b3c/fmed-12-1557241-g001.jpg

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