Pitcher W D
Pulmonary and Critical Care Medicine Division, University of Texas Southwestern Medical Center, Dallas.
Am J Med Sci. 1992 Mar;303(3):206-12. doi: 10.1097/00000441-199203000-00012.
Amiodarone is an effective antiarrhythmic agent whose utility is limited by many side-effects, the most problematic being pneumonitis. The pulmonary toxicity of amiodarone is thought to result from direct injury related to the intracellular accumulation of phospholipid and T cell-mediated hypersensitivity pneumonitis. The clinical and radiographic features of amiodarone-induced pulmonary toxicity are characteristic but nonspecific. The diagnosis depends on exclusion of other entities, such as heart failure, infection, and malignancy. While withdrawal of amiodarone leads to clinical improvement in majority of cases, this is not always possible or advisable. Dose reduction or concomitant steroid therapy may have a role in selected patients.
胺碘酮是一种有效的抗心律失常药物，但其效用因多种副作用而受到限制，其中最棘手的是肺炎。胺碘酮的肺毒性被认为是由与磷脂细胞内蓄积相关的直接损伤以及T细胞介导的过敏性肺炎所致。胺碘酮所致肺毒性的临床和影像学特征具有一定特点但缺乏特异性。诊断依赖于排除其他疾病，如心力衰竭、感染和恶性肿瘤。虽然停用胺碘酮在大多数情况下可使病情改善，但并非总是可行或可取。在部分患者中，减少剂量或联合使用类固醇治疗可能会有帮助。
