173.ABPA（过敏性支气管肺曲霉病）

每天朗读一段医学影像学英语文章

ABPA is on the spectrum of pulmonary disease caused by Aspergillus species and is characteristically seen in patients with a history of long-standing asthma and occasionally cystic fibrosis. A complex hypersensitivity reaction to the Aspergillus organisms, including a type I hypersensitivity reaction (IgE and IgG release) and type III hypersensitivity reaction (formation of antigen-antibody immune complexes) results in the attraction of eosinophils and mast cells leading to vasodilation and bronchoconstriction (65). The end result is plugs of inspissated mucus containing eosinophils and rare Aspergillus organisms in the segmental and subsegmental bronchi, with bronchial wall damage and bronchiectasis with mucoid impaction occurring as a result of excessive mucus production and abnormal ciliary function.

ABPA是曲霉菌导致的一系列肺疾病其中的一种，典型见于长期哮喘和偶发囊性纤维化的患者。由于患者对曲霉菌高度敏感，包括I型超敏反应（IgE和IgG释放）和III型超敏反应（抗原抗体复合物形成），导致嗜酸性粒细胞和肥大细胞聚集，引起血管舒张和支气管收缩。最终结局就是含有嗜酸性粒细胞和少量曲霉菌成分的浓缩粘液栓，堵塞段和亚段支气管。由于黏液分泌过多和纤毛摆动功能异常，导致气管壁破坏和支气管扩张。

Radiographic and CT findings in ABPA include bronchiectasis (especially saccular), bronchial wall-thickening, and tubular opacities in a bronchial distribution representing mucoid impaction in the abnormally dilated bronchi (“finger-inglove” opacities). These findings predominate in the upper and central airways. The impacted, inspissated mucus may have high attenuation (66). Secondary segmental or lobar atelectasis may occur.

ABPA平片和CT的表现包括：支气管扩张（特别是囊状支扩）、支气管壁增厚、由于粘液栓堵塞支气管导致其扩张形成管状致密影（指套征）。这些征象主要见于肺上叶和中央气道。浓缩的粘液栓可呈高密度。也可继发肺段和肺叶的不张。

Notes:

1. aspergillus 曲霉

2. asthma [ˈæzmə] n. 气喘，哮喘

3. eosinophils [i:oʊzɪ'nəfɪlz] 嗜酸粒细胞

4. mast cell [mæst sɛl] n. 肥大细胞

5. vasodilation [ˌveɪzoʊdaɪˈleɪʃn] n. 血管舒张

6. bronchoconstriction [brɒnt'ʃoʊkənstrɪkʃn] n. 支气管狭窄

7. inspissated ['ɪnspɪseɪtɪd] v. 浓缩

8. mucus [ˈmjukəs] n. 粘液

9. bronchi [ˈbrɑ:ŋkaɪ] n. 支气管

10. bronchiectasis [brɑŋkɪ'ektəsɪs] n. 支气管扩张

11. mucoid ['mju:kɔɪd] adj. 黏液样的

12. ciliary ['sɪlɪərɪ] adj. 睫毛的，纤毛的，毛状的

13. atelectasis [ˌætə'lektəsɪs] n. 肺不张

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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