阿斯伯吉勒斯结:自然史和抗真菌药物的作用
Chris Kosmidis1,2, Mahmoud Achira1, Jeremy Yong3
1National Aspergillosis Centre, Department of Infectious Diseases, Manchester University NHS Foundation Trust, Manchester, UK.
Mycoses
|March 19, 2024
概括
大多数Aspergillus结节在活检后保持稳定或改善,无论抗真菌治疗如何. 然而,慢性空腔性肺阿斯伯吉洛症 (CCPA) 可能会发展,需要对未切除的结节进行持续监测.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 阿斯珀吉勒斯结节是慢性肺部阿斯珀吉洛症的一个亚型.
- 最佳的管理和阿斯伯吉勒斯结的自然史并未得到很好的定义.
- 有限的数据存在于慢性空腔性肺炎 (CCPA) 的进展和抗真菌治疗的有效性.
研究的目的:
- 为了研究被诊断患有阿斯伯吉勒斯结的患者的临床过程.
- 评估抗真菌治疗对阿斯伯吉勒斯菌根结节的影响.
- 评估Aspergillus结节的进展到其他肺部疾病.
主要方法:
- 对23名经组织学确认的阿斯伯吉勒斯结体患者的回顾性分析.
- 对连续成像 (CT扫描) 的审查,以评估结节的演变.
- 抗真菌治疗方案和患者结果的文档,包括 CCPA 的进展.
主要成果:
- 在CT导向活检后,15.5个月内,在8名未接受治疗的患者中,结节保持稳定或大小减少.
- 一名患者在没有抗真菌治疗的情况下进行活检后发展为状细胞癌,另一个患者在没有抗真菌治疗后发展为CCPA.
- 在接受抗真菌药物治疗至少4周的5名患者中,结节稳定或减少;一个患者在3年后发展了CCPA.
- 没有接受手术切除的患者随后被诊断出患有CCPA.
结论:
- 阿斯伯吉勒斯结通常在活检后保持稳定或改善,独立于抗真菌治疗.
- 一部分患有阿斯伯吉路斯结节的患者可能会患上CCPA,这凸显了需要谨慎跟踪的需要.
- 外科切除似乎可以防止随后的CCPA诊断.
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