血液病患者侵袭性肺曲霉菌病研究进展

doi:10.3877/cma.j.issn.1674-1358.2022.03.001

中华实验和临床感染病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 145 -149. doi: 10.3877/cma.j.issn.1674-1358.2022.03.001

综述

血液病患者侵袭性肺曲霉菌病研究进展

冯丹¹, 姜尔烈¹^,^†(

)

^1. 300020　天津，中国医学科学院血液病医院（中国医学科学院血液学研究所），实验血液学国家重点实验室，国家血液系统疾病临床医学研究中心，细胞生态海河实验室

收稿日期:2021-09-18 出版日期:2022-06-15
通信作者: 姜尔烈
基金资助:
国家自然科学基金面上项目H0813.造血干细胞移植及并发症(No. 82070192)

Progress of invasive pulmonary aspergillosis in patients with hematological diseases

Dan Feng¹, Erlie Jiang¹^,^†()

^1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China

Received:2021-09-18 Published:2022-06-15
Corresponding author: Erlie Jiang

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侵袭性肺曲霉菌病（IPA）是恶性血液病患者，尤其是接受异基因造血干细胞移植人群真菌感染死亡的主要原因，早期诊治对于降低该类患者发病率和改善预后至关重要。然而，尽管IPA的诊治已有实验室生物学指标、病理及影像学多重证据支持，并已形成较为完善的诊治体系，但因受限于病变部位标本难以获取、非特异性的临床特征及预防性抗真菌药物的积极使用，早期诊断仍然具有挑战性。本综述从曲霉菌对恶性血液病患者的致病机理、临床表现、诊断标准、影像学及实验室检测等现有技术以及下一代基因测序（NGS）应用发展入手，探讨对恶性血液病患者发生IPA的认知及相关研究进展。

关键词: 恶性血液病, 侵袭性肺曲霉菌病, 下一代基因测序

Invasive pulmonary aspergillosis (IPA) is the main cause of death of fungal infection in patients with hematologic malignancies, especially in those receiving allogeneic hematopoietic stem cell transplantation. Early diagnosis and treatment is crucial to reduce morbidity and improve the prognosis. However, although the diagnosis and treatment of IPA had laboratory biology indexes, pathological and radiological data to support, and has formed a relatively complete system of diagnosis and treatment, but restricted to difficult obtain of the specimen, non-specific clinical features and prevented use of antifungal drugs, early diagnosis is still challenged. This article will discuss the understanding of IPA and related research progress on the pathogenesis, clinical manifestations, diagnostic criteria, current technologies including imaging and laboratory testing, and next-generation gene sequencing (NGS) applications in patients with hematological malignancies.

Key words: Hematological malignancies, Invasive pulmonary aspergillosis, Next generation sequencing

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