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新发传染病电子杂志 ›› 2024, Vol. 9 ›› Issue (6): 74-84.doi: 10.19871/j.cnki.xfcrbzz.2024.06.014

• 标准/指南/共识 • 上一篇    下一篇

肺结核后慢性肺曲霉病诊治专家共识

张培泽1, 赵曼曼2, 魏方军3, 史怀芳2, 邓国防4, 卢洪洲5   

  1. 1.深圳市第三人民医院肺病四科,广东 深圳 518112;
    2.深圳大学医学部,广东 深圳 518060;
    3.深圳市第三人民医院放射科,广东 深圳 518112;
    4.深圳市第三人民医院肺病二科,广东 深圳 518112;
    5.国家感染性疾病临床医学研究中心,广东 深圳 518112
  • 收稿日期:2024-10-12 出版日期:2025-01-25 发布日期:2025-01-25
  • 通讯作者: 卢洪洲, Email:luhongzhou@szsy.sustech.edu.cn;邓国防,Email:jxxk1035@yeah.net
  • 基金资助:
    1.国家自然科学基金(82070016); 2.广东省结核病临床研究中心(2020B1111170014); 3.深圳市结核病临床研究中心(20210617141509001); 4.深圳市科技计划项目(KCXFZ20211020163545004, RCJC20221008092726022); 5.深圳市医疗卫生“三名工程”项目(SZZYSM202311009)

Expert consensus on diagnosis and treatment of the post-tuberclulosis chronic pulmonary aspergillosis

Zhang Peize1, Zhao Manman2, Wei Fangjun3, Shi Huaifang2, Deng Guofang4, Lu Hongzhou5   

  1. 1. The Fourth Department of Pulmonary Diseases, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
    2. Shenzhen University Medical School, Guangdong Shenzhen 518060, China;
    3. Department of Radiology, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
    4. The Second Department of Pulmonary Diseases, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
    5. National Clinical Research Center for Infectious Disease (Shenzhen), Guangdong Shenzhen 518112, China
  • Received:2024-10-12 Online:2025-01-25 Published:2025-01-25

摘要: 慢性肺曲霉病是一种起病隐匿、症状不典型的疾病,具有较高的病死率。该病常发生在肺结核治愈后的残存空洞中,由于其症状与肺结核相近,临床上容易发生误诊。由于我国在肺结核后慢性肺曲霉病方面的临床研究数据相对较少,目前尚未制订出一套针对肺结核后慢性肺曲霉病的完整诊治规范。因此,本文参考了国内外的相关指南和共识,组织了结核病学、呼吸病学、感染病学、微生物学、影像学和病理学等多个领域的专家进行了集中研讨,共形成了13条推荐意见,旨在为肺结核后慢性曲霉病患者的规范化诊治和科学管理提供参考。这些推荐意见涵盖了流行病学、循证医学证据和临床诊治等多个方面,以期提高对肺结核后慢性肺曲霉病的诊疗水平,减少误诊和漏诊,改善患者的预后。

关键词: 慢性肺曲霉病, 肺结核后, 治疗, 专家共识, 诊断, 评估

Abstract: Chronic pulmonary aspergillosis (CPA) is a high fatality rate disease with atypical symptoms,and often occurring in residual cavities left after successful tuberculosis treatment. Due to its similar symptoms to tuberculosis, it is easy to be misdiagnosed. In China, a complete set of diagnosis and treatment norms for the post-tuberclulosis chronic pulmonary aspergillosis(post-TB CPA) has not been formulated. Therefore, this consensus referred to the relevant guidelines and consensus both domestically and internationally, organizing a centralized discussion among experts in the fields of tuberculosis, respiratory medicine, infectiology, microbiology, imaging and pathology. They formulated 13 recommendations to provide a reference for the standardized diagnosis and treatment and scientific management of patients with CPA after tuberculosis. These recommendations cover many aspects such as epidemiology, evidence-based medicine, and clinical diagnosis and treatment, aiming to improve the diagnosis and treatment level of post-TB CPA, reduce misdiagnosis and missed diagnosis, and ultimately improve patient outcomes.

Key words: Chronic pulmonary aspergillosis, Post-tuberclulosis, Treatment, Expert consensus, Diagnosis, Assessment

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