アミオダロンによる肺毒性の臨床的特徴
R E Dusman1, M S Stanton, W M Miles
1Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis 46202.
Circulation
|July 1, 1990
まとめ
アミオダロンの肺への毒性は,患者の5.8%に影響し,特に高齢者およびより高い維持用量を受けている患者に影響します. 低DLCOのような危険因子の早期発見は,この深刻な副作用を防ぐために極めて重要です.
科学分野:
- 心臓病学 心臓病学
- 肺内科 肺内科 肺内科
- 薬理学 薬理学とは
背景:
- アミオダロンは,広く使用されている抗不律性薬です.
- 肺の毒性は,アミオダロン治療の既知の,潜在的に深刻な副作用です.
- アミオダロン肺毒性 (APT) の発生率と予測要因を理解することは,患者の安全性にとって非常に重要です.
研究 の 目的:
- アミオダロン肺毒性 (APT) の発生率を,タキアリズム症の治療を受けている患者で決定する.
- APTの発達に関連した臨床予測要因を特定する.
- APTのリスクにおけるベースラインと治療パラメータの役割を評価する.
主な方法:
- アミオダロンで心室または心室上部のタキアリズムを治療した573人の患者の遡及的分析.
- APTの診断は,臨床的症状,放射線学的異常,および肺生検,DLCO,またはガリウム肺スキャンによって支持されます.
- 年齢,用量,および血薬剤濃度を含む予測要因を特定するための統計分析.
主要な成果:
- APTの発生率は5.8% (33/573人の患者) であり,研究期間中に累積リスクは9.1%であった.
- 高齢患者 (≥40歳) と,日平均維持用量 (>305 mg) がより高い患者で,より高い発症率が観察されました.
- 治療前のDLCOの低下と血デセチラミオダロン濃度の上昇は,APTのリスクの増加と関連していました.
結論:
- アミオダロンの肺への毒性は,特に高齢の患者および高い維持用投与を受けている患者において,重大なリスクである.
- 治療前のDLCOとプラズマのデセチラミオダロン濃度は,APTリスクの重要な指標として機能する可能性があります.
- アミオダロンによる肺損傷のリスクを軽減するために,密接なモニタリングと投与量調整が推奨されます.
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