过敏性支气管肺曲霉菌病的临床表现和治疗。

IF 2.3 3区 医学 Q2 CRITICAL CARE MEDICINE Seminars in respiratory and critical care medicine Pub Date : 2024-02-01 Epub Date: 2023-12-28 DOI:10.1055/s-0043-1776912
Ritesh Agarwal, Valliappan Muthu, Inderpaul S Sehgal
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引用次数: 0

摘要

过敏性支气管肺曲霉菌病(ABPA)是哮喘和囊性纤维化患者气道定植曲霉菌后产生的一种复杂的超敏反应。ABPA 的病理生理学涉及真菌与宿主免疫反应之间复杂的相互作用,导致持续的炎症和组织损伤。由于哮喘未得到控制,患者表现为慢性咳嗽、喘息和呼吸困难。特征性症状包括排出褐色粘液栓。影像学检查结果通常显示短暂的肺部浸润、支气管扩张和粘液嵌塞。然而,ABPA 的明确诊断需要结合临床、放射学和免疫学检查结果。治疗 ABPA 的目的是减轻症状、防止疾病恶化并将未来病情加重的风险降至最低。治疗方法包括全身使用糖皮质激素或抗真菌药物,以抑制炎症反应或真菌生长,防止病情恶化。病情严重或依赖糖皮质激素的患者可使用生物制剂。本综述概述了 ABPA 的临床表现和目前的治疗方案。
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Clinical Manifestation and Treatment of Allergic Bronchopulmonary Aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to airway colonization by Aspergillus fumigatus in patients with asthma and cystic fibrosis. The pathophysiology of ABPA involves a complex interplay between the fungus and the host immune response, which causes persistent inflammation and tissue damage. Patients present with chronic cough, wheezing, and dyspnea due to uncontrolled asthma. Characteristic symptoms include the expectoration of brownish mucus plugs. Radiographic findings often reveal fleeting pulmonary infiltrates, bronchiectasis, and mucus impaction. However, the definitive diagnosis of ABPA requires a combination of clinical, radiological, and immunological findings. The management of ABPA aims to reduce symptoms, prevent disease progression, and minimize the future risk of exacerbations. The treatment approach involves systemic glucocorticoids or antifungal agents to suppress the inflammatory response or fungal growth and prevent exacerbations. Biological agents may be used in patients with severe disease or glucocorticoid dependence. This review provides an overview of the clinical manifestations and current treatment options for ABPA.

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来源期刊
CiteScore
6.10
自引率
0.00%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The journal focuses on new diagnostic and therapeutic procedures, laboratory studies, genetic breakthroughs, pathology, clinical features and management as related to such areas as asthma and other lung diseases, critical care management, cystic fibrosis, lung and heart transplantation, pulmonary pathogens, and pleural disease as well as many other related disorders.The journal focuses on new diagnostic and therapeutic procedures, laboratory studies, genetic breakthroughs, pathology, clinical features and management as related to such areas as asthma and other lung diseases, critical care management, cystic fibrosis, lung and heart transplantation, pulmonary pathogens, and pleural disease as well as many other related disorders.
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