Objective To investigate the clinical characteristics and diagnosis of pulmonary aspergillosis and improve the diagnostic accuracy of the disease, reduce misdiagnosis.Methods A retrospective analysis 31 cases of hospitalized pa-tients with pulmonary aspergillosis from January 2005 to January 2015 at Xuanwu Hospital of Capital University of Medical Scie-nces;combined with literature analysis and summarize the clinical manifestation, imaging characteristics and the methods of diagnosis and treatment etc..Results Of the 31 patients, there were 29 cases (93.55%) with basis disease, and 2 cases (6.45%) in the normal population.The main symptoms of respiratory tract infection were lung dry and wet rales.In 31 ca-ses, misdiagnosis of 28 cases (90.32%), by lung biopsy diagnosed of 10 cases (32.25%), bronchoscopic sputum culture confirmed in 12 cases (38.70%), the GM test combined with clinical features diagnosis of 6 cases (19.35%), the sputum smear found in fungi in 3 cases (9.68%).Diagnosis of 16 cases of invasive pulmonary aspergillosis, 10 cases of allergic bronchopulmonary aspergillosis, 5 cases of pulmonary aspergilloma.Laboratory tests showed a decrease in serum globulin and chest CT in 18 patients (58.06%) with bilateral lung lesion, 2 cases (6.45%) of the left lung disease, and 11 cases (35.48%) of the right lung lesions.In 31 patients, surgical resection were performed in 6 cases, partial lesion resection re-ceived voriconazole therapy in 6 cases and more than 19 cases were treated with voriconazole therapy.Cured 17 cases, im-proved in 10 cases, no change in 3 cases, 1 case of death.Conclusion The onset of occult pulmonary aspergillosis, clinical manifestations are not specific, it is easy to misdiagnosed and missed diagnosis.To improve the understanding of the disease, appropriate application of effective diagnostic methods, to give the correct diagnosis is to carry out effective treatment, reduce the mortality.%目的：探讨肺曲霉菌病的临床特点及诊断方法，提高对本病的诊断准确性，减少误诊。方法回顾性分析2005年1月—2015年1月在首都医科大学宣武医院诊断为肺曲霉菌病的住院患者31例，结合文献分析，总结其临床表现、影像学特征及诊疗方法等。结果31例患者中，有基础疾病29例（93}．55％），无基础疾病2例（6．45％）。主要症状为呼吸道感染，主要体征为双肺干、湿性啰音。31例患者中初诊误诊28例（90．32％），经肺组织活检病理学确诊10例（32．25％），经支气管镜痰培养确诊12例（38．70％），经GM试验结合临床特征明确诊断6例（19．35％），经口痰涂片找到真菌3例（9．68％）。诊断为侵袭性肺曲霉菌16例，变应性支气管肺曲霉菌病10例，肺曲霉菌球5例。实验室检查主要有血清球蛋白水平降低，胸部 CT 示双肺病变18例（58．06％），左肺病变2例（6．45％），右肺病变11例（35．48％）。31例患者中，行外科手术切除治疗6例，行部分病灶切除治疗后给予伏立康唑治疗6例，余19例患者给予伏立康唑治疗。治愈17例，好转10例，无变化3例，死亡1例。结论肺曲霉菌病起病隐匿，临床表现缺乏特异性，很容易误诊和漏诊。提高对该病的认识，恰当应用有效的诊断方法，给予正确的诊断是进行有效治疗，降低病死率的关键。
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