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find Keyword "肺曲霉病" 22 results
  • b>Advances in pathogenesis of invasive pulmonary aspergillosis

    曲霉在自然界中广泛分布,约20种曲霉能感染人类和动物,其中最常见的有烟曲霉、黄曲霉、土曲霉和黑曲霉等。曲霉孢子在空气中传播,人吸入后曲霉可以在气道内定植、致敏、感染,当人体免疫功能低下时可产生危及生命的侵袭性肺曲霉病(IPA)。近年来IPA发病率呈上升趋势,已成为仅次于念珠菌病的主要肺部真菌感染性疾病[1]。虽然IPA已成为器官移植受者、恶性血液病和恶性肿瘤患者等高危人群的重要死因,但对其发病机制了解甚少。本文着重论述近年来IPA发病机制的研究进展。

    Release date:2016-09-14 11:53 Export PDF Favorites Scan
  • 非血液/恶性肿瘤患者侵袭性肺曲霉病11例临床分析

    肺曲霉病是由曲霉感染或吸入曲霉病原引起的一组急慢性肺部病变,临床上一般将肺曲霉病分为曲菌球、变态反应性支气管肺曲霉病和侵袭性肺曲霉病(IPA)三种类型,其中IPA危害最大、病死率最高。现将复旦大学附属中山医院呼吸科2005年4月~2007年4月诊断的11例IPA报告如下。

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • Efficacy and Safety of Inhaled Amphotericin B in Prophylaxis of Invasive Pulmonary Aspergillosis: A Meta-analysis

    Objective To evaluate the efficacy and safety of inhaled amphotericin B ( AmB) in prophylaxis of invasive pulmonary aspergillosis ( IPA) in both animal studies and clinical researches. Methods MEDLINE, ISI, EMBASE and Wanfang Periodical Databases were searched until march 2011 for case-control study on the efficacy and safety of inhaled AmB in prophylaxis of IPA. The articles were evaluated according to inclusion criteria. Poor-quality studies were excluded, and RevMan 4. 22 sofeware was applied for investigating the heterogeneity among individual studies and calculating the pooled odds ratio ( OR) and 95% confidence interval ( CI) . Results Five animal studies with a total of 626 animals were included. The overall survival rate of the immunosuppressed animals with pulmonary aspergillosis treated with nebulized AmB was increased ( 38.3% vs. 9.7% , OR=13.93, 95% CI 7.46 ~26.01, Plt;0. 000 01) . Six clinical trials including 1354 patients were considered. Our meta-analysis showed that inhaled AmB could significantly reduce the incidence rate of IPA ( 2.6% vs. 9.2% , OR=0.27, 95% CI 0.16 ~0.46, P lt;0. 000 01) , but had no definite benefit on mortality. Four studies evaluated the potential side effects of nebulized AmB and showed that there were no significant adverse events. Conclusions Empirical inhaled AmB is associated with a lower rate of IPA but no significant

    Release date:2016-09-13 04:00 Export PDF Favorites Scan
  • 变态反应性支气管肺曲霉病一例及文献复习

    目的 报道并分析1例变态反应性支气管肺曲霉病(ABPA)的诊断和治疗。 方法 采用病例报告的方式对2010年10月至2011年9月1例ABPA病例进行分析。 结果 患者诊断ABPA明确,治疗效果明显。 结论 ABPA临床早期诊断困难,需要尽早进行痰培养、血清总IgE等相关检查以明确诊断,激素和抗真菌药物是目前有效的治疗方法,早期诊断、早期治疗能改善患者预后。

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  • Misdiagnostic Causes of Pulmonary Aspergillosis

    【摘要】 目的 探讨并分析导致肺曲霉病患者误诊的原因,为早期诊断并及时正确治疗提供科学的依据。 方法 回顾性分析2010年1-4月间确诊为肺曲霉病的3例患者在诊治过程中被误诊的原因。 结果 3例患者均缺乏明显的特异性临床表现和影像学表现,最后确诊均依据病理学活检证实。 结论 肺部的曲霉菌感染缺乏特异性的临床和影像学表现,及早行纤维支气管镜检查或肺组织活检可提高早期诊断率。【Abstract】 Objective To analyze the misdiagnostic causes of pulmonary aspergillosis. Methods The clinical data of three patients with pulmonary aspergillosis from January to April 2010 were retrospectively analyzed, and the misdiagnostic causes were analyzed. Result No specific clinical and imaging findings were found in the three patients, and pulmonary aspergillosis was finally diagnosed according to the pathological biopsy. Conclusion Pulmonary aspergillus lacks specific clinical and imaging manifestations; early fiberoptic bronchoscopy or pulmonary biopsy may improve the rate of accurate diagnosis.

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 变应性支气管肺曲霉病中心型支气管扩张一例

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • The blood clotting dysfunction and therapeutic efect of low molecular hepa~n in a mouse model of invasive pulmonary aspergillosi

    Objective To investigate the blood clotting dysfunction of invasive pulmonary aspergillosis(IPA)and the therapeutic effect of low molecular hepafin in a mouse model.Methods The neutropenic IPA mouse model was constructed by being given cyclophosphamide to depress immunologic function,and then intranasally challenged with Aspergillus fumigatus conidia.(1)Blood clotting function were assessed by bleeding time,clotting time,platelet count and antithrombase-III(AT-III)activity.Seventy-two mice were randomly assigned into 4 groups.Group A received only normal saline.group B received normal saline to substitute the cycloph0sphamide,and the rest equal to group D.Group C received normal saline to substitute the AspergiUus fumigatus conidia suspension,and the rest equal to group D.Group D(model group)received cyclophosphamide(intraperitoneally,150 mg/kg,d4,d1)and Aspergillus fumigatus conidia suspension(intranasally,40 μL/mouse,1.5×10∧5/mL,d0).Six mice were randomly sacrificed in each group for analysis of blood clotting function per 24 h after inoculation for 3 times.(2)Therapeutic effect of low molecular heparin was determined by survival time of IPA mice.One hundred and eighteen mice were randomly assigned into 4 groups after challenged with 6×10 conidia/mouse and received one of the following regimens daily from dl to d7 after challenge,vehicle(group E,n=29),low molecular heparin(group F,n=30,subcutaneous injection,1000 IU/kg,qd×7 d),amphotericin B(group G,n=29,intraperitoneal,1 m kg,qd×7 d),low molecular heparin plus amphotericin B(group H,n=30).Mice survivals were recorded once daily to d21 after innoculation.Results (1)AT-III activity of group D decreased significantly 24 h after innoculation.Bleeding time and clotting time decreased significantly and AT—III activity decreased sequentially 48 h after innoculation.The platelet decreased significantly 72 h after innoculation,and bleeding time shoaened further.Clotting time was longer than that 0f 48 h.but still shorter than norm al and AT-III activity decreased sequentially.There were significant differences when comparing group D with group A,B and C(all Plt;0.01).And there was no significant difference between group A,B and C(all Pgt;0.05).(2)Survival analysis indicated that the therapeutic effect of low molecular hepafin plus amphotericin B was better than that of amphotericin B or low molecular heparin alone.No therapeutic effect was found in group F(group E vs group F,Pgt;0.05,both group E and group F compared with group H,P lt;0.01.Group H vs group G,P lt;0.05.Both group E and group F compared with group G,P lt;0.05).Conclusions The results suggest that there is blood clotting dysfunction in IPA mice and AT—III activity may be an early index to monitor the disfunction.Compared with the therapeutic effect of amphoterinein B alone,low molecular hepafin plus amphoterincin B can prolong survival of neutropenic IPA mice

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • Features of Allergic Bronchopulmonary Aspergillosis on X-ray and Computed Tomography

    ObjectiveTo investigate the chest radiographic and computed tomographic manifestations of allergic bronchopulmonary aspergillosis (ABPA). MethodWe retrospectively analyzed the chest radiographic and computed tomographic manifestations of 20 ABPA patients treated between December 2005 and December 2013. ResultsChest radiograph showed that there were 4 negative cases, 14 cases of solid mass, 10 cases of increased and disorder of bronchovascular shadows, and 5 cases of bronchiectasis. Chest computed tomography showed that there were one negative case, 18 cases of bronchiectasis, 17 cases of central bronchiectasis among which central and peripheral bronchi were involved in 6 cases and 1 case presented as pure peripheral bronchiectasis, 11 cases of tree-in-bud signs, 6 cases of mucous embolism, 8 cases of solid mass, 5 cases of ground-glass opacity, 4 cases of pleural thickening, 3 cases of pleural effusion, and 2 cases of atelectasis. ConclusionsFor asthma and cystic fibrosis patients, central bronchiectasis on chest CT indicates the diagnosis of ABPA, but it cannot be considered as a characteristic feature. Bronchiectasis combined with high attenuation mucus may be a characteristic feature of ABPA although it is rare.

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  • Clinical Analysis of Four Cases of Allergic Bronchopulmonary Aspergillosis and Literature Review

    ObjectiveTo investigate the clinical manifestations, diagnosis and treatments of allergic bronchopulmonary aspergillosis (ABPA). MethodsThe clinical data of four cases of ABPA diagnosed in our department between 2009 and 2014 were analyzed. The related literature was also reviewed. ResultsABPA tends to occur in people with chronic lung diseases, such as asthma and cystic fibrosis. The main clinical manifestations are wheezing, fever, cough, and sputum production. Laboratory examinations include immediate Aspergillus skin test reactivity, elevated total serum IgE and Aspergillus specific IgE and IgG antibodies, and peripheral blood eosinophilia. Radiological findings include recurrent chest roentgenographic infiltrates and central bronchiectasis. Treatments involve corticosteroids and antifungal therapy with itraconazole. ConclusionsABPA is easy to misdiagnosis clinically. It should be considered in patients with poor controlled asthma and asthmatic patients with acute pulmonary infiltrates. Early diagnosis and proper treatment can minimize lung injury from ABPA and improve outcomes.

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  • 经纤维支气管镜诊断曲霉感染100例分析

    目的探讨纤维支气管镜检查在肺曲霉感染诊断中的作用。 方法回顾性分析2012年至2014年我院100例曲霉感染患者的临床资料及纤维支气管镜(简称纤支镜)检查结果。 结果100例曲霉感染患者中, 男65例, 女35例, 年龄12~85岁, 30岁以下患者15例。62例合并基础疾病, 包括20例结核, 23例肿瘤, 6例慢性阻塞性肺疾病。36例患者经纤支镜病理检查确诊, 其中4例经纤支镜肺活检确诊, 无并发症发生; 64例患者纤支镜灌洗液或痰液曲霉培养阳性, 属于临床诊断。 结论纤支镜病理检查及灌洗液培养是诊断肺曲霉感染的有效手段, 若临床情况允许, 应尽早进行纤支镜检查明确诊断。

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