Rakita L, Sobol S M, Mostow N, Vrobel T
Am Heart J. 1983 Oct;106(4 Pt 2):906-16. doi: 10.1016/0002-8703(83)90015-7.
Of the side effects that complicate amiodarone therapy, pulmonary fibrosis is potentially the most serious. Therefore, the development of techniques to predict the onset of this troublesome reaction would be of great practical value. Reports of 39 patients who developed pulmonary toxicity with amiodarone were evaluated for clues to precipitating factors and information on the response to corticosteroid treatment. The majority of patients were being given maintenance doses greater than 400 mg/day. Patients appeared to improve after withdrawal of amiodarone, both with and without corticosteroid treatment. In addition, a case report is presented of a patient who developed pulmonary changes that disappeared when amiodarone was withdrawn and did not recur when amiodarone was reinstituted. Data from sequential pulmonary function tests and cumulative amiodarone dosage in 35 patients were also examined to determine their value in predicting pulmonary complications. Pulmonary function tests did not appear to be useful in predicting the likelihood of an individual patient's developing pulmonary complications. Although none of the available information identifies the mechanism mediating amiodarone pulmonary toxicity, the frequency of the complication probably can be reduced by timely reductions in maintenance dosage.
在使胺碘酮治疗变得复杂的副作用中，肺纤维化可能是最严重的。因此，开发预测这种麻烦反应发生的技术具有很大的实用价值。对39例发生胺碘酮所致肺毒性的患者报告进行了评估，以寻找诱发因素的线索以及关于皮质类固醇治疗反应的信息。大多数患者接受的维持剂量大于400毫克/天。无论是否接受皮质类固醇治疗，停用胺碘酮后患者似乎都有改善。此外，还报告了1例患者，其肺部改变在停用胺碘酮时消失，重新使用胺碘酮时未复发。还检查了35例患者的系列肺功能测试数据和累积胺碘酮剂量，以确定它们在预测肺部并发症方面的价值。肺功能测试似乎对预测个体患者发生肺部并发症的可能性没有帮助。尽管现有信息均未确定介导胺碘酮肺毒性的机制，但通过及时减少维持剂量可能可以降低并发症的发生率。
