Meurice J C, Debacque I, Boita F, Underner M, Bouquet S, Preud'Homme J L, Patte F
Pathol Biol (Paris). 1986 Dec;34(10):1074-80.
We report 6 cases of diffuse interstitial pneumonia complicating therapy. The patients' study included the determination of amiodarone plasma level by high performance liquid chromatography (HPLC) and a study of lymphocyte subpopulations in alveolar lavage (wash cut). The mean cumulative dosage of amiodarone was 229 g; clinical symptoms were mainly weight loss, asthenia, dyspnea and dry cough. Bronchiolo-alveolar lavage fluids contained numerous lymphocytes, of which were T cells with a predominance of T8 lymphocytes. This is compatible with an immunoallergic mechanism as suggested in allergic alveolitis and in other drug induced pulmonary diseases. The determination of plasma amiodarone level performed after amiodarone withdrawal consistently showed a level inferior to the toxic one. These data confirm the lack of correlation between the pneumonitis outbreak and the amiodarone plasma level. Study of the red cell concentration of amiodarone and its major metabolites seems to be of greater interest.
我们报告了6例弥漫性间质性肺炎并发治疗的病例。对患者的研究包括通过高效液相色谱法（HPLC）测定胺碘酮血浆水平以及对肺泡灌洗（洗出液）中的淋巴细胞亚群进行研究。胺碘酮的平均累积剂量为229克；临床症状主要为体重减轻、乏力、呼吸困难和干咳。支气管肺泡灌洗液中含有大量淋巴细胞，其中以T细胞为主，T8淋巴细胞占优势。这与过敏性肺泡炎和其他药物性肺病中所提示的免疫过敏机制相符。胺碘酮停药后测定的血浆胺碘酮水平始终显示低于中毒水平。这些数据证实了肺炎发作与胺碘酮血浆水平之间缺乏相关性。对胺碘酮及其主要代谢产物的红细胞浓度进行研究似乎更有意义。
