Khalid M, Al Saghir A, Saleemi S, Al Dammas S, Zeitouni M, Al Mobeireek A, Chaudhry N, Sahovic E
Section of Pulmonary Medicine, Dept of Medicine, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia.
Eur Respir J. 2005 Mar;25(3):490-3. doi: 10.1183/09031936.05.00020804.
Bronchiolitis obliterans (BO) is a serious noninfectious pulmonary complication following allogeneic bone marrow transplantation (BMT). Azithromycin, a macrolide antibiotic, may have a beneficial effect in BO through its anti-inflammatory effect. The aim of the current study was to investigate the potential effect of azithromycin on pulmonary function tests (PFTs) in BO complicating BMT. PFTs of 153 post-BMT patients were followed; eight patients out of 153 (12%) developed obstructive airway disease on their PFTs, along with characteristic findings of BO on high-resolution computed tomography of the chest. These patients were given azithromycin 500 mg q.d. for 3 days, followed by 250 mg three times a week for 12 weeks. Clinically significant improvements were achieved both in forced vital capacity, where the mean (95% confidence interval) increase reported was 410 mL (0.16-0.65), which was an average improvement of 21.57%, and in the forced expiratory volume in one second, where the mean increase noticed was 280 mL (0.10-0.44), which was an average improvement of 20.58%. In conclusion, the potential role of azithromycin in the treatment of bronchiolitis obliterans is intriguing and it warrants further testing.
闭塞性细支气管炎（BO）是异基因骨髓移植（BMT）后一种严重的非感染性肺部并发症。阿奇霉素是一种大环内酯类抗生素，可能通过其抗炎作用对BO产生有益影响。本研究的目的是探讨阿奇霉素对BMT合并BO患者肺功能测试（PFT）的潜在影响。对153例BMT术后患者的PFT进行了随访；153例患者中有8例（12%）在PFT中出现阻塞性气道疾病，同时胸部高分辨率计算机断层扫描显示有BO的特征性表现。这些患者给予阿奇霉素500mg每日一次，共3天，随后每周三次，每次250mg，持续12周。在用力肺活量方面取得了具有临床意义的改善，报告的平均（95%置信区间）增加量为410mL（0.16 - 0.65），平均改善率为21.57%；在一秒用力呼气量方面也有改善，平均增加量为280mL（0.10 - 0.44），平均改善率为20.58%。总之，阿奇霉素在闭塞性细支气管炎治疗中的潜在作用令人感兴趣，值得进一步研究。
