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[胺碘酮所致肺病。一种常未被认识的医源性疾病]

[Pneumopathy caused by amiodarone. An often unrecognized iatrogenic entity].

作者信息

Bensaid J, Guéret P, Blanc P, Doumeix J J, Virot P, Pinaud D, Bontemps T, Vergnoux H, Leymarie J L, Melloni B

出版信息

Ann Cardiol Angeiol (Paris). 1987 Jun;36(6):307-12.

PMID:3619385
Abstract

Three cases of interstitial pneumopathy secondary to amiodarone are reported, in addition to almost 200 cases previously published in the literature. The main clinical, radiological, biological and evolutive characteristics are reminded in emphasizing the advantages of bronchioalveolar irrigation. Some factors seem to be predisposing, without any definite proof however. They are: high daily dosage, long term treatment, high cumulative dose, concomitant ingestion of another anti-arrhythmic medication, especially in elderly patients, and in patients who, before any treatment, presented a decreased total pulmonary capacity and a CO transfer capacity lower than 80 p. cent of the theoretical values. Discontinuation of amiodarone and administration of steroids usually produce a rapid regression of the clinical and radiological symptoms.

摘要

除了文献中先前已发表的近200例病例外,本文还报告了3例胺碘酮继发的间质性肺病。文中回顾了主要的临床、放射学、生物学及病情演变特征,强调了支气管肺泡灌洗的优势。一些因素似乎是诱发因素,但尚无确凿证据。这些因素包括:每日高剂量、长期治疗、高累积剂量、同时服用另一种抗心律失常药物,尤其是老年患者,以及在任何治疗前肺总量降低且一氧化碳转运能力低于理论值80%的患者。停用胺碘酮并给予类固醇通常会使临床和放射学症状迅速消退。

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