阿米奥达龙诱导的肺毒性的临床特征
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
概括
阿米奥达龙的肺毒性影响5.8%的患者,特别是老年人和服用更高维护剂量的患者. 早期识别风险因素,如较低的DLCO,对于防止这种严重的副作用至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿米奥达龙是一种广泛使用的抗心律失常药.
- 肺毒性是一种已知的,可能是阿米奥达龙治疗的严重不良反应.
- 了解amiodarone肺毒性 (APT) 的发生率和预测因素对于患者的安全至关重要.
研究的目的:
- 为了确定阿米奥达龙肺毒性 (APT) 的发病率,在接受治疗的患者中,以节拍不良.
- 确定与APT发展相关的临床预测因素.
- 评估基线和治疗参数在APT风险中的作用.
主要方法:
- 对573名因心室或心室上动脉节律不良而接受阿米奥达龙治疗的患者进行了回顾性分析.
- 基于临床症状,放射性异常,并通过肺活检,DLCO或肺扫描支持APT的诊断.
- 统计分析以确定预测因素,包括年龄,剂量和血药物度.
主要成果:
- 在研究期间,APT发生率为5.8% (33/573名患者),累计风险为9.1%.
- 在老年患者 (≥40岁) 和接受更高平均每日维持剂量 (>305毫克) 的患者中观察到更高的发病率.
- 较低的预治疗DLCO和较高的血甲基胺水平与APT风险增加有关.
结论:
- 阿米奥达龙的肺毒性是一个显著的风险,特别是在老年患者和那些接受高维持剂量的患者中.
- 治疗前的DLCO和血中甲基胺水平可能是APT风险的重要指标.
- 建议进行密切监测和剂量调整,以减轻阿米奥达龙诱导的肺损伤风险.
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