Snyder L S, Hertz M I
Pulmonary Medicine Division, University of Minnesota, Minneapolis.
Semin Respir Infect. 1988 Sep;3(3):217-28.
Cytotoxic drug-induced pulmonary disease is a major cause of morbidity and mortality in immunocompromised patients. It is estimated that 20% of all patients receiving cytotoxic drugs will develop a symptomatic pulmonary reaction. Therefore, the possibility of a toxic drug reaction must be considered in all patients developing pulmonary disease during or following treatment with these agents. Clinical manifestations of lung toxicity are nonspecific and parallel the signs and symptoms of diffuse lung infection and malignant disease in the chest. For this reason, the diagnosis of cytotoxic drug-induced lung damage is one of exclusion of the various opportunistic infections that afflict this patient population. This typically requires careful microbiologic studies of bronchoalveolar lavage (BAL) samples and lung tissue. The diagnosis of cytotoxic drug-induced lung injury is often vexing. In the future, (BAL) may assume a more prominent diagnostic role and suggest insights into the pathogenesis of this entity.
细胞毒性药物引起的肺部疾病是免疫功能低下患者发病和死亡的主要原因。据估计，所有接受细胞毒性药物治疗的患者中有20%会出现有症状的肺部反应。因此，在所有接受这些药物治疗期间或之后发生肺部疾病的患者中，必须考虑药物毒性反应的可能性。肺部毒性的临床表现是非特异性的，与胸部弥漫性肺部感染和恶性疾病的体征和症状相似。因此，细胞毒性药物引起的肺损伤的诊断是排除困扰该患者群体的各种机会性感染之一。这通常需要对支气管肺泡灌洗（BAL）样本和肺组织进行仔细的微生物学研究。细胞毒性药物引起的肺损伤的诊断常常令人烦恼。未来，支气管肺泡灌洗（BAL）可能会发挥更重要的诊断作用，并为该疾病的发病机制提供见解。
