2-沈茜-20120707变应性支气管肺曲菌病课稿.ppt

思考2 尽管ABPA—CB的影像学非常具有 特征， 但仍可以与肺炎，结核及肿瘤混淆 不清。 思考3 对于目前的糖皮质激素联合伊曲康唑的治疗模式，我们是否有 补救治疗 甚或更佳的一线治疗 A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis. Stevens DA, Schwartz HJ, Lee JY N Engl J Med. 2000 Mar 16;342(11):756-62. Anti-inflammatory effect of itraconazole in stable allergic bronchopulmonary aspergillosis: a randomized controlled trial. Wark PA, Hensley MJ, Saltos N, et al. J Allergy Clin Immunol 2003; 111:952–957 Successful treatment of allergic bronchopulmonary aspergillosis with recombinant anti-IgE antibody. Allergic bronchopulmonary aspergillosis (ABPA) can cause severe worsening of the respiratory condition in patients with cystic fibrosis. Treatment can result in steroid dependency and serious adverse events. A dramatic and rapid improvement of respiratory symptoms and lung function after a single dose of anti-IgE antibody (omalizumab) in a 12-year-old girl with cystic fibrosis and ABPA is described. This is the first report of this experimental treatment. It suggests an important role for IgE in the pathogenesis of ABPA and offers new therapeutic possibilities van der Ent CK, Hoekstra H, Rijkers GT Thorax. 2007 Mar;62(3):276-7 Mulliez P, Croxo C, Roy-Saint Georges F, et al. Allergic broncho-pulmonary aspergillosis treated with voriconazole. Rev Mal Respir 2006; 23:93–94 Bandrés Gimeno R, Mu?oz Martínez MJ. Prolonged therapeutic response to voriconazole in a case of allergic bronchopulmonary aspergillosis. Arch Bronconeumol 2007; 43:49–51 小 结 ABPA患者应该有更多，早期发现及诊断才能使患者最大获益。 相信治疗ABPA患者的方法应该会有进展并突破，值得我们临床期待并实践。 夏日风起 荷香沁人 * * * ? * * * * 奥马佐单抗 * Abstract Allergic bronchopulmonary aspergillosis is a lung disease characterized by an immune response to several antigens of Aspergillus species. Corticosteroids are the treatment of choice in the acute phase, although some studies have shown the efficacy o