变应性支气管肺曲霉病血清学诊断的研究进展  

Progress of serological biomarkers in making diagnosis of allergic bronchopulmonary Aspergillosis

作　　者：王金香 李誉海 阮晓云 刘宝义[1] Wang J inxiang Li Yuhai Ruan Xiaoyun Liu Baoyi(Department of Respiratory Medicine, Qilu Hospital of Shandong University, Qingdao 250012, China)

机构地区：[1]山东大学齐鲁医院呼吸内科,青岛266000

出　　处：《国际呼吸杂志》2017年第20期1587-1591,共5页International Journal of Respiration

摘　　要：变应性支气管肺曲霉病（allergicbronchopulmonaryAspergillosis，ABPA）在囊性纤维化或哮喘患者中是一种常见的临床综合征，可导致不可逆的支气管扩张、肺纤维化，甚至死亡。ABPA的早期诊断及治疗可预防不可逆的肺部损伤。尽管多个APBA的诊断标准被先后提出，然而其临床和影像学特点与囊性纤维化、哮喘曲霉过敏有部分重叠，所以诊断上仍存在一定困难。因此，有效的血清标志物对于ABPA的诊断非常关键。从众所周知的标志物如总血清免疫球蛋白E（immunoglobulinE，IgE）、烟曲霉特异性IgE、烟曲霉特异性免疫球蛋白G（immunoglobulinG，IgG）、沉淀素到新的血清生物标志物如曲霉菌抗原重组体（recombinantAspergillusfumigatusallergen，rAsp）、胸腺活性调节趋化因子（thymusglandactivityregulatingchemokine，TARC）、嗜碱细胞活性试验（basophiliccellsactivitytest，BAT）、细胞过敏原刺激实验（cellallergenstimulationtest，CAsT），结合文献复习上述血清标志物在提高APBA早期发现及诊断中的地位及有效性。Allergic bronchopulmonary Aspergillosis （ABPA） is a common clinic syndrome in patients with cystic fibrosis （CF） or asthma, and it can induce long-term pulmonary damage such as bronchiectasis and fibrosis, even death. Early diagnosis and early treatment of ABPA is supposed to reduce symptoms, to improve lung function, and to prevent irreversible lung damage. Although multiple APBA diagnostic criteria were successively put forward, however ABPA in clinical and radiographic features with cystic fibrosis and allergic asthma aspergillus have overlap, so there are still some difficulties in making diagnosis. Therefore, it is critical for ABPA to finding effective serum biomarkers. New biomarkers have been found in the immunal pathogenesis research process of ABPA, such as Aspergillus antigen recombinant （rAsp）, thymus gland activity regulating chemokine （TARC/CCL17）, basophilic cells activity test （BAT）, cell allergen stimulation test （CAST）, have important significance in the diagnosis. This article will focus on the serum markers that can improve the diagnosis of ABPA, from the well- known markers （total IgE, specific IgE, Aspergillus, cigarette smoke, precipitin aspergillus specific IgG） to the new biomarkers （rAsp, TARC, BAT, CAST）. We review the position and effectiveness of the serum markers in improving APBA early diagnosis combining with the literatures.

关 键 词：变应性支气管肺曲霉病 胸腺活性调节趋化因子 曲霉菌抗原重组体 嗜碱性细胞活性试验 细胞过敏原刺激试验 

分 类 号：R519[医药卫生—内科学]