Pietinalho A, Ohmichi M, Löfroos A B, Hiraga Y, Selroos O
Mjölbolsta Hospital, Karis, Finland.
Sarcoidosis Vasc Diffuse Lung Dis. 2000 Jun;17(2):158-66.
The frequency and clinical picture of sarcoidosis are different in Finland and Hokkaido, Japan. The aim of this study was to compare the normalisation rate of chest radiographic changes in patients with biopsy-proven sarcoidosis.
The chest radiographs of 437 Finnish and 457 Japanese patients were used and, for the purpose of this study, double-checked in order to make sure that the interpretations were identical. On a yearly basis the radiographs were classified as normalised, improved, unchanged or deteriorated.
Normalisation of chest radiographs occurred in 73% of the Japanese and 40% of the Finnish patients. The difference between the two series was significant (p < 0.001). Gender, young age, presence or absence of symptoms or extrapulmonary lesions at diagnosis or treatment with corticosteroids did not influence the difference between the two series. Of the 191 Finnish and 309 Japanese patients with initial stage I disease a normal chest radiograph was obtained in 47% of the Finnish and 76% of the Japanese patients (p < 0.001), despite the fact that the Finnish series included patients with erythema nodosum, who had a 59% normalisation rate. Of the 186 Finnish and 125 Japanese patients with initial stage II disease, normalisation of the chest radiographs was seen in 36% of the Finnish and in 73% of the Japanese patients (p < 0.001). No difference in normalisation rate was seen between stage III patients.
The prognosis of pulmonary sarcoidosis in Japanese patients in Hokkaido is significantly better than that in Finland defined as normalisation rate of the chest radiographs.
芬兰和日本北海道结节病的发病率及临床表现有所不同。本研究旨在比较经活检证实的结节病患者胸部X线改变的正常化率。
采用437例芬兰患者和457例日本患者的胸部X线片，为确保解读一致，本研究进行了二次检查。每年将X线片分类为正常化、改善、不变或恶化。
日本患者胸部X线片正常化率为73%，芬兰患者为40%。两组之间的差异具有显著性（p < 0.001）。性别、年龄、诊断时有无症状或肺外病变，以及是否使用糖皮质激素治疗均不影响两组之间的差异。在191例芬兰和309例日本I期疾病初始患者中，芬兰患者胸部X线片正常化率为47%，日本患者为76%（p < 0.001），尽管芬兰组包括结节性红斑患者，其正常化率为59%。在186例芬兰和125例日本II期疾病初始患者中，芬兰患者胸部X线片正常化率为36%，日本患者为73%（p < 0.001）。III期患者的正常化率无差异。
北海道日本患者肺部结节病的预后明显优于芬兰患者，以胸部X线片正常化率衡量。
