20例变态反应性支气管肺曲霉病误诊分析  

Analysis of misdiagnosis of 20 cases of allergic bronchopulmonary aspergillosis

作　　者：徐芳[1] 

机构地区：[1]武汉市第一医院呼吸内科,湖北武汉430022

出　　处：《中国现代医学杂志》2012年第26期87-89,共3页China Journal of Modern Medicine

摘　　要：目的对20例误诊的变态反应性支气管肺曲霉菌(ABPA)患者的临床特点进行分析,提高临床诊断率。方法回顾性分析该院近10年中20例误诊的ABPA患者的临床表现、实验室检查及影像学特点,总结误诊原因。结果 20例ABPA患者只有4例有哮喘病史,10例否认任何特殊病史,10例否认特殊职业接触史;确诊前被误诊支气管哮喘10例、支气管扩张6例、肺结核3例;主要临床表现喘气80%、咳痰65%、双肺哮鸣音50%;影像学特点双肺多发浸润影,形态表现为片状影、团块影、黏液栓等,以上中肺多见。结论 ABPA的既往史、职业接触史、临床表现、影像学特点存在多变性及诊断的复杂性是误诊的主要原因,病理学检查可以减少误诊,提高早期诊断率。【Objective】 To increase the rate of clinical diagnosis by analyzing clinical characteristics of 20 patients with allergic bronchopulmonary aspergillosis（ABPA）.【Methods】 The clinical manifestations,laboratory tests,imaging features of 20 misdiagnosed ABPA patients hospitalized our hospital in recent 10 years were retrospectively analyzed.【Results】 In 20 ABPA patients only 4 cases had asthma history,10 cases denied any special history,10 cases denied special occupational contact history;Before confirmed 10 ABPA patients were misdiagnosed bronchial asthma,6 cases were misdiagnosed bronchiectasis,3 cases were misdiagnosed tuberculosis;the main clinical manifestations were dysnpea 80%,sputum 65%,lung wheezing 50%;the main features of chest X-ray were bilateral lung multi-infiltrating more involving above lung including patchy forms,mass shadow,central bronchiectasis,mucus plugs,etc.【Conclusions】 The variability of ABPA＇s past history,occupational exposure history,clinical manifestations,imaging features and the complexity of the diagnosis were the main reasons for misdiagnosis,so pathological examination could reduce misdiagnosis and improve early diagnosis rate.

关 键 词：变态反应性支气管肺曲霉菌 误诊 

分 类 号：R562.2[医药卫生—呼吸系统]