Griffith David E, Brown-Elliott Barbara A, Shepherd Sara, McLarty Jerry, Griffith Lee, Wallace Richard J
Professor of Medicine, University of Texas Health Center, 11937 U.S. Highway 271, Tyler, TX 75708, USA.
Am J Respir Crit Care Med. 2005 Jul 15;172(2):250-3. doi: 10.1164/rccm.200407-863OC. Epub 2005 Apr 28.
Ethambutol (EMB) is an important component of multidrug treatment regimens for Mycobacterium avium complex lung disease. Ocular toxicity is the most important potential EMB toxicity, especially in the elderly population with M. avium complex lung disease. Two hundred twenty-nine patients with M. avium complex lung disease, 55% women and 53% with nodular/bronchiectatic disease, received a mean of 16.1 +/- 10.8 months of multidrug therapy that included EMB. Fifty patients (22%) were known to have preexisting ocular disease. While on EMB, 97 (42%) patients consulted an opthalmologist and 24 (10%) stopped EMB at least temporarily. Eight of 139 patients (6%) on daily therapy were diagnosed with EMB ocular toxicity, whereas 0 of 90 patients on intermittent therapy had EMB ocular toxicity (p = 0.05). All patients with EMB ocular toxicity developed symptoms between outpatient clinic appointments; none were diagnosed with routine visual acuity and color vision testing. All patients with EMB ocular disease returned to baseline ocular status after discontinuation of EMB. Intermittent EBM administration was associated with less ocular toxicity than daily EMB administration in this patient population.
乙胺丁醇（EMB）是鸟分枝杆菌复合群肺病多药治疗方案的重要组成部分。眼部毒性是EMB最重要的潜在毒性，尤其是在患有鸟分枝杆菌复合群肺病的老年人群中。229例鸟分枝杆菌复合群肺病患者，55%为女性，53%患有结节性/支气管扩张性疾病，接受了平均16.1±10.8个月的包括EMB的多药治疗。已知50例患者（22%）有眼部疾病史。在使用EMB期间，97例患者（42%）咨询了眼科医生，24例患者（10%）至少暂时停用了EMB。每日治疗的139例患者中有8例（6%）被诊断为EMB眼部毒性，而间歇治疗的90例患者中无1例出现EMB眼部毒性（p=0.05）。所有发生EMB眼部毒性的患者在门诊预约之间出现症状；均未通过常规视力和色觉测试确诊。所有患有EMB眼部疾病的患者在停用EMB后眼部状态恢复到基线。在该患者群体中，间歇给予EMB比每日给予EMB的眼部毒性更小。
