修订的ISHAM-ABPA工作组临床实践指南,用于诊断,分类和治疗过敏支气管肺/肌瘤
Ritesh Agarwal1, Inderpaul Singh Sehgal2, Valliappan Muthu2
1Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India agarwal.ritesh@outlook.in.
目前已有针对过敏性支气管肺性阿斯伯吉洛症 (ABPA) 和真菌菌病 (ABPM) 的更新指南. 这些建议涵盖了成人和儿童的诊断,分类和治疗,并纳入了真菌病管理的最新进展.
科学领域:
- 医学真菌学 医学真菌学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 现有的国际人类和动物真菌学会 (ISHAM) 对过敏支气管肺炎 (ABPA) 的指导方针已经有十年了.
- 诊断和治疗方面的进步需要对ABPA管理建议进行更新.
研究的目的:
- 制定更新的共识指南,用于管理过敏性支气管肺炎 (ABPA) 和过敏性支气管肺菌 (ABPM).
- 为成人和儿童的ABPA/M诊断,分类和治疗提供基于证据的建议.
主要方法:
- 采用了经过修改的Delphi方法,涉及一个国际专家组.
- 共识被定义为在两轮在线会议和一次面对面会议上≥70%的同意或不同意.
主要成果:
- 对A.A.进行查. 对于新诊断的喘息成年人和难以治疗的喘息儿童,建议使用烟雾剂敏感化.
- ABPA的诊断标准包括真菌敏感化,总IgE升高以及特定的临床/放射学发现. 当Aspergillus特异性IgE正常,但存在其他真菌敏感性时,就会考虑过敏性支气管肺结核病 (ABPM).
- 建议在急性ABPA中使用口服普得尼索隆或伊特拉科纳单疗法,在复发性恶化中使用组合疗法. 无症状的ABPA患者不接受常规治疗.
结论:
- 已经建立了对ABPA/M的诊断,分类和治疗的共识指南.
- 这些指导方针旨在改善患者护理,促进真菌呼吸道疾病的研究.
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