结节病67例临床分析  

Sarcoidosis:clinical analysis of 67 cases

作　　者：孙继萍[1] 方向群[1] 陈良安[1] 

机构地区：[1]解放军总医院呼吸科,北京市100853

出　　处：《中华老年多器官疾病杂志》2008年第1期36-39,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨结节病的临床特点和诊断方法。方法回顾分析解放军总医院自1996年来经组织病理学确诊的67例结节病患者的临床资料。结果女性多于男性,男∶女为1∶2.0,平均发病年龄47.1岁。其中0期5例,Ⅰ期26例,Ⅱ期33例,Ⅲ期3例。呼吸道症状以咳嗽胸闷气促最多,分别占52.2%(35/67)、41.8%(28/67)和38.8%(26/67)。全身症状主要为乏力消瘦(28.4%)和发热(20.1%)。血清血管紧张素转换酶阳性率为83.0%。经气管镜支气管黏膜活检和肺组织活检阳性率分别为78.6%和72.7%,纵隔镜活检阳性率100%。结论结节病临床表现无特异性,对有肺门纵隔淋巴结肿大的可疑病例,应尽可能作组织病理学检查明确诊断。Objective To explore the clinical features and diagnosis of sarcoidosis. Methods Clinical materials of 67 consecutive patients with biopsy-proven sarcoidosis were retrospectively analyzed. Results There were more female patients than males and the ratio of males to females was 1 ： 2.0. The average age was 47. 1 years. There were 5, 26, 33 and 3 cases in stage 0, Ⅰ, Ⅱ and Ⅲ respectively. The main symptoms of respiratory tract included cough （52.2%）, chest distress （41.8%） and anhelation （38.8%）. The main general symptoms included hypodynamia, emaciation and fever. Eighty-three per cent of the patients had high levels of serum angiotensin converting enzyme. The diagnosis was confirmed in 78.6 % by the transbronchical mucosa biopsies and 72.7% by the transbronchial lung biopsies. The diagnosis was confirmed in 100% by lymph node biopsy through mediastinoscopy. Conclusion No specific clinical manifestation may occur in the cases of sarcoidosis. Pathological examination should be made for the prevention of missed diagnosis and misdiagnosis.

关 键 词：结节病 活组织检查 临床特点 诊断 病例 

分 类 号：R593.9[医药卫生—内科学]