Underner M, Perriot J, Wallaert B, Peiffer G, Meurice J-C, Jaafari N
Unité de recherche clinique intersectorielle en psychiatrie, consultation de tabacologie, centre hospitalier Henri-Laborit, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France.
Dispensaire Emile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France.
Rev Mal Respir. 2018 Feb;35(2):134-148. doi: 10.1016/j.rmr.2017.06.005. Epub 2018 Feb 17.
In France, cocaine is the second most commonly illicit drug used after cannabis. Cocaine, mainly smoked in the form of crack, can be responsible for a wide range of respiratory disorders. The aim of this systematic literature review was to clarify what is known about the link between cocaine use and alveolar hemorrhage. We performed a Medline search covering the period 1980-2016 and collected data from 84 articles. The number of acute forms described in the literature is small but postmortem studies show that hidden forms are frequent. The diagnosis is based on the association of hemoptysis, anemia and diffuse alveolar opacity. Bronchoalveolar lavage shows hemosiderin-laden macrophages. Of the 13 cases identified, 12 patients had hemoptysis, anemia and diffuse alveolar infiltration on pulmonary or chest CT. In 9 cases, the presence of hemosiderin-laden macrophages was identified in bronchoalveolar lavage or pulmonary biopsy. Except for 2 deaths, the outcome was favorable when cocaine use was stopped. Systematic interventions to help people stopping using this psychoactive substance will protect lung health.
在法国，可卡因是继大麻之后第二大最常用的非法药物。可卡因主要以快克的形式吸食，可导致多种呼吸系统疾病。本系统文献综述的目的是阐明关于可卡因使用与肺泡出血之间联系的已知情况。我们对1980年至2016年期间进行了Medline检索，并从84篇文章中收集了数据。文献中描述的急性病例数量较少，但尸检研究表明隐匿性病例很常见。诊断基于咯血、贫血和弥漫性肺泡混浊的关联。支气管肺泡灌洗显示含铁血黄素巨噬细胞。在确诊的13例病例中，12例患者在肺部或胸部CT上有咯血、贫血和弥漫性肺泡浸润。9例病例在支气管肺泡灌洗或肺活检中发现了含铁血黄素巨噬细胞。除2例死亡外，停止使用可卡因后预后良好。帮助人们停止使用这种精神活性物质的系统性干预措施将保护肺部健康。
