摘要
41例过敏性支气管肺曲霉病(ABPA)患者的胸部x线照片严重程度分期系统是否与标准血/血清诊断指标相关的问题得到了解决。哮喘和烟曲霉(AF)血清学阳性被认为是基本的诊断纳入标准。同时检测嗜酸性粒细胞计数、血清免疫球蛋白E和即刻皮肤过敏反应,将患者分为“确定”或“可能”ABPA。明确的病例有上述五种因素,而可能的病例有三种或更多。胸片由经验丰富的放射科医师检查,对临床资料不了解。六个阶段的影像学评分(0-5)是基于所见变化的严重程度和持续时间:0阶段:正常;第一阶段:短暂的恶性通货膨胀;阶段2:瞬时微小变化;第三阶段:短暂的重大变化;第四阶段:永久的微小变化; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.