小结
定义
病史和体格检查
关键诊断因素
- 排痰性咳嗽
- 劳累时呼吸急促
- 当前吸烟者
- 瓦斯、烟雾以及/或尘土的暴露
- 肝肿大
- 腹水
- 意识模糊
其他诊断因素
- 32-41岁年龄
- 男性
- 哮鸣音
- 胸部充气过度
- 巩膜黄疸/黄疸
- 扑翼样震颤
危险因素
- AAT 缺乏的家族史
诊断性检查
首要检查
- 血浆AAT水平
- 肺功能测试
- 胸部 X 线检查
- 胸部 CT
- 肝功能检查 (LFT)
需考虑的检查
- 表型分型
- 基因分型
- 基因测序
- 运动试验及动脉血气分析
- 甲胎蛋白
- 肝脏超声
- 腹部 CT
治疗流程
低血浆AAT
撰稿人
作者
D. Kyle Hogarth, MD, FCCP
Professor
Pulmonary and Critical Care
University of Chicago
Chicago
IL
利益声明
DKH has given lectures for Grifols and Takeda, makers of alpha-1 antitrypsin related products. He serves on the data safety and monitoring board for a study conducted by InhibRx and is the principal investigator for studies sponsored by Vertex and Takeda. DKH is an author of a number of references cited in this topic.
鸣谢
Dr D. Kyle Hogarth would like to gratefully acknowledge Dr Paul J. Hutchison, a previous contributor to this topic.
利益声明
PJH declares that he has no competing interests.
同行评议者
Jane Deng, MD
Assistant Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles
CA
利益声明
JD declares that she has no competing interests.
Franck Rahaghi, MD
Chair of Quality
Director
Pulmonary Hypertension Clinic
Head
Pulmonary Education and Rehabilitation
Department of Pulmonary, Allergy and Critical Care
Cleveland Clinic Florida
Weston
FL
利益声明
FR has been a consultant and speaker and has received funding from Baxter Healthcare and CSL Behring.
Graeme P. Currie, MD, FRCP
Consultant Chest Physician
Aberdeen Royal Infirmary
Aberdeen
UK
利益声明
GPC declares that he has no competing interests.
鉴别诊断
- 哮喘
- 慢性阻塞性肺疾病 (COPD)
- 支气管扩张症
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