上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (3): 353-.doi: 10.3969/j.issn.1674-8115.2011.03.025

• 论著（临床研究） • 上一篇    下一篇

胸内结节病的临床特征及治疗分析

江银玲1, 赵 珩2, 牛艳洁1, 韩宝惠1, 姜丽岩1   

  1. 上海交通大学附属胸科医院 1.肺内科, 2.胸外科, 上海 200030
  • 出版日期:2011-03-28 发布日期:2011-03-29
  • 通讯作者: 姜丽岩, 电子信箱: jiang_liyan2000@yahoo.com.cn。
  • 作者简介:江银玲（1985—）, 女, 硕士生；电子信箱: shirleyjyl@163.com。
  • 基金资助:

    上海市科委基础重点项目（09JC1413000）

Analysis of clinical characteristics and treatment of intrathoracic sarcoidosis

JIANG Yin-ling1, ZHAO Heng2, NIU Yan-jie1, HAN Bao-hui1, JIANG Li-yan1   

  1. 1.Department of Respiratiory Medicine, 2.Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2011-03-28 Published:2011-03-29
  • Supported by:

    Major Foundamental Research Program of Shanghai Science and Technology Committee, 09JC1413000

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摘要：

目的 分析胸内结节病的临床特点、诊治方法及疗效。方法 收集55例胸内结节病患者的临床资料，对患者的临床特征及治疗过程和效果进行回顾性分析。结果 55例患者中女性多于男性，发病高峰在51~60岁。临床表现非特异性，以咳嗽最常见，部分患者无症状。39例患者接受糖皮质激素治疗，4例在激素减量过程中出现病情反复，给予激素加量并行缓慢减量后好转；1例停药4年后复发，重新给予激素治疗，随访6年至今未复发。接受激素治疗的患者中，常见的不良反应依次为肥胖、消化性溃疡和骨质疏松；未发生威胁生命的并发症。结论 胸内结节病主要临床表现为咳嗽；患者长期接受激素治疗，应严密监测不良反应。

关键词: 结节病, 临床表现, 治疗, 皮质激素, 副作用

Abstract:

Objective To investigate the clinical characteristics,diagnosis, treatment and prognosis of intrathoracic sarcoidosis. Methods The clinical data of 55 patients with intrathoracic sarcoidosis were collected, and the clinical characteristics, treatment process and prognosis were retrospectively analysed. Results Among the 55 patients, females were more than males, and patients aged between 51 and 60 years accounted for the majority. There was no specific manifestation, and cough was the most common symptom, while some patients were free from symptoms. Thirty-nine patients received treatment with glucocorticoids. Four of the 39 patients aggravated during tapering of glucocorticoids, and got better after treatment with a larger dose and tapering moderately. One of the 39 patients relapsed 4 years after glucocorticoids withdrawl, and no longer relapsed for 6 years after a second treatment with glucocorticoids. The adverse effects in patients treated with glucocorticoids were obesity, peptic ulcer and osteoporosis, while no life-threatening complications occurred. Conclusion The main clinical manifestation of intrathoracic sarcoidosis is cough, and the adverse effects should be intensively monitored for the long-term use of glucocorticoids.

Key words: sarcoidosis, clinical manifestation, treatment, glucocorticoid, adverse effect