囊性纤维化患者中过敏性支气管肺曲霉病的危险因素及烟曲霉菌的致敏作用  

Risk factors for allergic bronchopulmonary aspergillosis and sensitisation to aspergillus fumigatus in patients with cystic fibrosis

作　　者：Ritz N. Ammann R.A. Casaulta Aebischer C. M.H. Schoeni 朱新菊 

机构地区：[1]Department of Paediatrics, University of Berne, 3010 Berne, Switzerland

出　　处：《世界核心医学期刊文摘（儿科学分册）》2006年第2期19-20,共2页

摘　　要：An increasing incidence of allergic bronchopulmonary aspergillosis (ABPA) as a complication in patients with cystic fibrosis (CF) is reported. The objective of this retrospective case-control study was to assess potential risk factors for ABPA and for Aspergillus fumigatus sensitisation (AFS). In a group of 160 CF patients, 11 (7% ) fulfilled the diagnostic criteria for ABPA and 20 (13% ) had evidence of AFS. They were compared to 62 control CF patients (25 for ABPA and 37 for AFS group) without evidence of ABPA or AFS using extended matching for sex, age and weight. AFS patients had received significantly higher cumulative doses of inhaled corticosteroids than their respective controls (OR 8.0; 95% CI 1.74-63). Bronchial colonisation with Stenotropho monasmaltophilia was strongly and independently associated with ABPA (OR 20; 95% CI 2.8-infinity). A longer duration of Pseudomonas aeruginosa colonisation was independently associated with AFS (OR per year 1.50; 95% CI 1.12-infinity). Conclusion: Cystic fibrosis patients with allergic bronchopulmonary aspergillosis have a more frequent isolation of S. maltophilia in their sputum than their controls. Longer duration of colonisation with P. aeruginosa is a risk factor for Aspergillus fumigatus sensitisation. Higher cumulative doses of inhaled corticosteroids are associated with Aspergillus fumigatus sensitisation and their role as a risk factor needs to be clarified.An increasing incidence of allergic bronchopulmonary aspergillosis （ABPA） as a complication in patients with cystic fibrosis （CF） is reported. The objective of this retrospective case-control study was to assess potential risk factors for ABPA and for Aspergillus fumigatus sensitisation （AFS）. In a group of 160 CF patients, 11 （7%） the diagnostic criteria for ABPA and 20 （13%） fulfilled had evidence of AFS. They were compared to 62 control CF patients （25 for ABPA and 37 for AFS group） without evidence of ABPA or AFS using extended matching for sex, age and weight. AFS patients had received significantly higher cumulative doses of inhaled corticosteroids than their respective controls （OR 8.0; 95% CI 1.74-63）. Bronchial colonisation with Stenotropho monasmaltophilia was strongly and independently associated with ABPA （OR 20; 95% CI 2.8- infinity） A longer duration of Pseudomonas aeruginosa eolonisation was independently associated with AFS （OR per year I. 50; 95% CI 1.12 - infinity）. Conclusion： Cystic fibrosis patients with allergic bronehopulmonary aspergillosis have a more frequent isolation of S. maltophilia in their sputum than their controls. Longer duration of colonisation with P. aeruginosa is a risk factor for Aspergillus fumigatus sensiti.

关 键 词：潜在危险因素 囊性纤维化 支气管内 肺曲霉病 致敏作用 烟曲霉菌 过敏性 患者 嗜麦芽黄单胞菌 病例对照研究 

分 类 号：R473.6[医药卫生—护理学] R563[医药卫生—临床医学]