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乙胺碘呋酮肺毒性发生率一般为1～6%,其促发因素最为重要的是与药物维持剂量的大小有关,维持量>400mg/d 时容易发生肺毒性。发病机理可能是药物的直接毒性和药物所致的免疫反应。临床上多数以亚急性起病,有呼吸困难、咳嗽等症状,通常于治疗后1年内发生。胸部X 线呈非特异性改变,大多显示两肺弥漫性间质和(或)肺泡浸润.动脉血气和肺功能检查常提示低氧血症、限制性通气功能障碍和弥散功能障碍。对长期服用乙胺碘呋酮的患者,当出现呼吸道症状或胸片上出现新的浸润阴影时,应高度怀疑有肺毒性可能,经纤维支气管镜作肺活检和支气管肺泡灌洗液检查有助于诊断。一旦明确诊断,应及时停药,并加用皮质激素治疗。
The incidence of amiodarone pulmonary toxicity generally 1 to 6%, the most important triggers of its trigger factor is the size of the drug to maintain the dose, the maintenance dose> 400mg / d susceptible to pulmonary toxicity. Pathogenesis may be the direct toxicity of drugs and drug-induced immune response. Most clinical sub-acute onset, dyspnea, cough and other symptoms, usually within 1 year after treatment. Chest X-ray showed non-specific changes, most of which showed diffuse interstitial lung and (or) alveolar infiltration.Arterial blood gas and pulmonary function tests often suggest hypoxemia, restrictive ventilation dysfunction and diffuse dysfunction. Long-term use of amiodarone in patients with respiratory symptoms or chest shadow appear on the new infiltration of shadow should be highly suspected of lung toxicity possible, bronchoscopy for lung biopsy and bronchoalveolar lavage fluid check helps diagnosis. Once a clear diagnosis, should be promptly discontinued, and add corticosteroids.