呋喃唑酮诱导急性肺部毒性临床病例分析

Clinical Cases Analysis of Furazolidone-induced Acute Pulmonary Toxicity

关键词:  呋喃唑酮  急性肺毒性  间质  药物不良反应

Key words:  furazolidone  acute pulmonary toxicity  interstitial  adverse drug reaction

摘要:

目的 总结呋喃唑酮诱导急性肺部反应的临床特征、病程和转归，提高呋喃唑酮肺部毒性的认识。方法 回顾性分析9例使用呋喃唑酮后出现急性肺损伤住院患者的临床特征、实验室检查、治疗手段及临床结局。结果 使用呋喃唑酮后发生肺部毒性反应平均时间为(9.78±3.15) d，首发症状均为发热。早期胸部影像特征为双肺小叶间隔增厚、小叶内线状影及小叶内间质增厚等肺间质改变。所有患者就诊时停用呋喃唑酮，其中8例未接受糖皮质激素治疗。总体好转率为100%，5例患者出院前复查CT提示间质改变吸收。结论 治疗幽门螺杆菌的重要药物呋喃唑酮可引起肺间质改变为特征的急性肺毒性，需严密监测以便及时发现和处理。

Abstract:

OBJECTIVE To summarize clinical features,course and outcome of furazolidone-induced acute pulmonary reactions,and to improve the understanding of furazolidone associated the pulmonary toxicity.METHODS A retrospective analysis including clinical characteristics,laboratory tests,treatments and outcomes was made on 9 hospitalized cases of acute lung injury which were attributed to furazolidone.RESULTS Acute pulmonary reactions appeared a mean of (9.78±3.15) d after the start of furazolidone treatment,their initial manifestation was fever.Early chest imaging feature was pulmonary interstitial changes containing bilateral interlobular septa thickening,intralobular lines and intralobular interstitial thickening.Furazolidone therapy was discontinued in all patients at visit,8 cases did not receive glucocorticoid therapy.The improving rate in general was 100%,5 cases reexamining CT indicated interstitial changes were absorbed before discharge.CONCLUSION Furazolidone as an important drug for treatment of Helicobacter pylori infection may induce acute pulmonary toxicity characterized by interstitial changes,need to monitor closely,so as to find and process it timely.