目的：通过分析硼替佐米治疗多发性骨髓瘤患者过程中出现的急性肺损伤相关临床资料，提高对硼替佐米致急性肺损伤（ ALI）这一严重并发症的认识。方法回顾性分析150例次采用含硼替佐米治疗的多发性骨髓瘤患者的资料，分析5例出现ALI患者的症状及体征，血清学、病原学和影像学检测结果，以及治疗过程、转归情况，并进行文献复习。结果硼替佐米治疗多发性骨髓瘤所致ALI为其罕见并发症，具有起病急、病情进展快的特点，临床以发热、干咳、呼吸困难为主要表现，可有双肺干湿啰音，血气分析存在低氧血症，可合并呼吸衰竭，微生物检查通常阴性，偶有患者可合并感染，胸部CT表现为双肺弥漫性渗出，部分患者大剂量激素联合机械通气治疗有效。结论硼替佐米可致部分多发性骨髓瘤患者发生严重ALI，在应用过程中需提高警惕。%Objective To analyze the clinical data of multiple myeloma patients who manifested acute lung injury ( ALI) after bortezomib treatment .Methods Data were collected from 150 cases of multiple myeloma patients who were treated with bortezomib .There were five patients who indicated ALI and underwent serological , pathogenic , and imaging tests.Their courses of treatment and outcome were reviewed .Results Bortezomib induced ALI was a rare complication in multiple myeloma patients , which was characterized by acute onset and high progression .The main clinical manifesta-tions included fever, cough, and dsypnea, moist rale in the lungs, hypoxemia, as well as respiratory failure.The results of microorganism tests were often negative , with occasional infections in the patients .According to chest CT scanning , bi-lateral pulmonary infiltrates were found , some of which could be treated with high doses of corticosteroids combined with mechanical ventilation .Conclusion Bortezomib may cause sever ALI in some multiple myeloma patients , which need to be carefully used during treatment .
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