药物相关性弥漫性肺泡出血综合征2例报道及文献复习

摘要

目的 提高对药物相关性弥漫性肺泡出血综合征(DAHS)临床特点的认识.方法 对我院确诊的2例药物性弥漫性肺泡出血综合征患者的临床资料进行分析.结果 2例确诊患者均为成人,均有明确的药物暴露史,起病急,临床表现为:咯血、贫血、呼吸困难和双肺弥漫性浸润影,相关感染、心衰、免疫学指标阴性,肺部HRCT、肺功能检查和支气管肺泡灌洗是诊断的主要手段,糖皮质激素治疗效果良好.结论 DAHS是一种多种原因导致的少见的临床综合症,药物也是引起DAHS的重要病因.药物相关性DAHS为除外性诊断,需与其他原因的DAHS鉴别,强调本病的早期诊断和及时、正规的治疗.%Objective To increase awareness of drug-associated diffuse alveolar hemorrhage syndromes(DAHS). Methods Two cases of drug-associated DAHS patients were retrospectively analyzed and the correlative literatureswere reviewed. Results Two cases of diagnosed patients were adults, aged 29 years and 81 years old, have a clear history of drug exposure, rapid onset, clinical manifestations are: hemoptysis, anemia, dyspnea and diffuse bilateral pulmonary infiltrates, associated infections, heart failure, immune indexes negative, pulmonary HRCT, pulmonary function tests and bronchoalveolar lavage is the primary means of diagnosis, Steroid therapy had good effects. Conclusions DAH is a rare clinical syndromes. Drugs are also an important cause of DAHS. Drug-associated DAH is a diagnosis of exclusion of other causes of DAH. Early accurate diagnosis, appropriate treatment are critical for the management of DAH.