pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-2-246-253pulmo-708Research ArticleОБЗОРЫREVIEWПоражение легких как осложнение терапии амиодарономLung injury as a complication of treatment with amiodaroneВатутинН. Т.VatutinN. T.

д. м. н., профессор, зав. кафедрой госпитальной терапии ГО «Донецкий национальный медицинский университет им. М.Горького», и. о. зав. отделом неотложной и восстановительной кардиохирургии ГУ «Институт неотложной и восстановительной хирургии им. В.К.Гусака НАМН Украины»; тел.: (38062) 385-05-17;

MD, Professor, Head of Department of Hospital Internal Medicine, M.Gor'kiy Donetsk National Medical University; tel.: +38062-385-05-17;

kafedra_vatutin@mail.ruТарадинГ. Г.TaradinG. G.

 к. м. н., доцент кафедры госпитальной терапии ГО «Донецкий национальный медицинский университет им. М.Горького»; тел.: (38062) 385-05-17;

PhD, Associate Professor at Department of Hospital Internal Medicine, M.Gor'kiy Donetsk National Medical University; tel.: +38050-055-08-05;

taradin@inbox.ruГриценкоЮ. П.GritsenkoYu. P.

студент IV курса медицинского факультета № 1 ГО «Донецкий национальный медицинский университет им. М.Горького»; тел.: (38062) 385-05-17;

the 4th year student of Medical Faculty, M.Gor'kiy Donetsk National Medical University; tel.: +38062-385-05-17;

y1grytsenko@gmail.comГО «Донецкий национальный медицинский университет им. М.Горького»: 83003, Украина, Донецк, пр. Ильича, 16; ГУ «Институт неотложной и восстановительной хирургии им. В.К.Гусака НАМН Украины»: 83000, Украина, Донецк, Ленинский проспект, 47УкраинаM.Gor'kiy Donetsk National Medical University: 16, Il'icha av., Donetsk, 83005, Ukraine; V.K.Gusak' State Institute of Emergent and Reconstructive Surgery, National Academy of Medical Science: 47, Leninskiy av., Donetsk, 83000, UkrainеUkraineГО «Донецкий национальный медицинский университет им. М.Горького»: 83003, Украина, Донецк, пр. Ильича, 16;УкраинаM.Gor'kiy Donetsk National Medical University: 16, Il'icha av., Donetsk, 83005, Ukraine;Ukraine201624062016262246253Copyright © Ватутин Н.Т., Тарадин Г.Г., Гриценко Ю.П., 20162016Ватутин Н.Т., Тарадин Г.Г., Гриценко Ю.П.Vatutin N.T., Taradin G.G., Gritsenko Y.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/708

В обзоре представлены литературные данные об одном из самых опасных побочных эффектов антиаритмического препарата III класса амиодарона – поражении легких, т. н. амиодарон-индуцированной легочной токсичности (АИЛТ). Проанализированы данные о распространенности этого осложнения, факторов, предрасполагающих к его развитию, взаимосвязь дозировок, длительности приема амиодарона и вероятности АИЛТ. Освещены вопросы клинической фармакологии и наиболее распространенных побочных эффектов амиодарона. Описаны патофизиологические, патоморфологические особенности, клинические проявления и осложнения АИЛТ, включая диффузный пневмонит, бронхиолит, дыхательную недостаточность и острый респираторный дистресс-синдром. С целью диагностики АИЛТ отмечены характерные результаты лабораторных, инструментальных методов исследования, в частности оценка функции внешнего дыхания, рентгенография органов грудной клетки, компьютерная томография высокого разрешения и биопсия легких. Лечебные приемы при ведении пациентов с АИЛТ включают снижение дозировки, полное прекращение приема препарата и назначение глюкокортикостероидов. В профилактических целях для снижения риска развития АИЛТ рекомендована изначальная спирометрическая оценка функции легких, рентгенографический контроль и информирование пациентов о возможных проявлениях этого тяжелого легочного осложнения при лечении амиодароном.

This is a review of current literature on lung injury which is one of the most hazardous adverse effects of an antiarrhythmic agent amiodarone referred to as amiodarone-induced pulmonary toxicity (AIPT). Finding on AIPT prevalence, risk factors, dose dependence, therapy duration and probability of AIPT occurrence have been analyzed. Issues of clinical pharmacology and the most common adverse effects of amiodarone have been discussed. Pathophysiological and pathological features and clinical manifestations of AIPT including diffuse pneumonitis, bronchiolitis, respiratory failure and acute respiratory distress syndrome have been described. Diagnosis of AIPT is based on routine methods such as lung function tests, chest X-ray, high-resolution computed tomography, and lung tissue biopsy. Management approaches include dose reduction or drug withdrawal and administration of systemic steroids. Preventive measures include baseline spirometry, regular X-ray examination and information about symptoms of this complication provided to the patients.

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The authors declare that there are no conflicts of interest present.