Mayaud C, Schlemmer B, Denis M, Nahmias G, Penaud D, Akoun G
Centre de Pneumologie et de Réanimation respiratoire, Hôpital Tenon, Paris.
Rev Pneumol Clin. 1988;44(3):113-21.
Lung diseases that occur in patients with drug-induced bone marrow aplasia are part of a wider group of lung diseases in immunocompromised patients. Their most common causes are infections due to Gram-negative bacilli, staphylococci or Aspergillus spp. and intra-alveolar haemorrhages. Their diagnostic approach is often limited by disorders of coagulation, risks of infection by bronchial or pulmonary seeding during endoscopy and the lethal risk of mechanical ventilation after bronchoalveolar lavage in patients with respiratory failure. The therapeutic approach is frequently empirical due to the fact that antibiotic therapy cannot be delayed, even for a few hours, and to the aforementioned diagnostic problems. In practice, the diagnostic and therapeutic approaches usually result from a rational compromise depending on whether the lung disease has occurred at the onset or at the end of an episode of bone marrow aplasia.
药物性骨髓再生障碍患者发生的肺部疾病是免疫功能低下患者中更广泛的肺部疾病群体的一部分。其最常见的病因是革兰氏阴性杆菌、葡萄球菌或曲霉属感染以及肺泡内出血。其诊断方法常常受到凝血障碍、内镜检查期间支气管或肺部播散导致感染的风险以及呼吸衰竭患者支气管肺泡灌洗后机械通气的致死风险的限制。由于抗生素治疗即使延迟几个小时也不能进行，以及存在上述诊断问题，治疗方法常常是经验性的。实际上，诊断和治疗方法通常是根据肺部疾病是在骨髓再生障碍发作开始时还是结束时发生而做出的合理折衷。
