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[结节病中的急性淋巴细胞性肺泡炎]

[Acute lymphocytic alveolitis in sarcoidosis].

作者信息

Peros-Golubicic T, Bekić A, Tomasić-Cvitanović S

机构信息

Klinicka bolnica za plućne bolesti "Jordanovac", Zagreb.

出版信息

Lijec Vjesn. 1992 Jan-Apr;114(1-4):6-10.

PMID:1343030
Abstract

Lymphocytic alveolitis is the characteristic feature of active sarcoidosis. High intensity alveolitis (more than 28% of lymphocytes in bronchoalveolar lavage fluid) implicates, according to some authors, specific, most often poor prognosis. Twenty-seven patients with active pulmonary sarcoidosis were grouped according to the intensity of lymphocytic alveolitis. In the first group, there were 13 patients with high intensity alveolitis (more than 28% of lymphocytes in bronchoalveolar lavage fluid, average 42.8 +/- 12%) and in the second group 14 patients with low intensity alveolitis (less than 28% of lymphocytes in bronchoalveolar lavage fluid, average 13.3 +/- 6.5%). The groups did not differ with regard to sex, chest radiologic stage or the number of relapses. All the patients had pulmonary function tests: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), diffusion capacity (DLCO), and rest and exercise arterial blood oxygen tension. The high intensity alveolitis group had significantly lower FVC (p < 0.01) and FEV1 (p < 0.05) as compared with the low intensity alveolitis group, what indicates that the high intensity alveolitis group of patients had more advanced pulmonary disease and was accordingly more often treated with corticosteroids (69.2%). Nine patients with high intensity alveolitis and ten with low intensity were followed up for 6 months. In the group with high intensity alveolitis there was a statistically significant improvement of DLCO (p < 0.01) what could be explained by a frequent use of corticosteroids in this group. Chest radiogram in the high intensity alveolitis group showed complete clearing in one patient only and incomplete in eight.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

淋巴细胞性肺泡炎是活动性结节病的特征性表现。一些作者认为,高强度肺泡炎(支气管肺泡灌洗液中淋巴细胞超过28%)意味着特定情况,且通常预后较差。27例活动性肺部结节病患者根据淋巴细胞性肺泡炎的强度进行分组。第一组有13例高强度肺泡炎患者(支气管肺泡灌洗液中淋巴细胞超过28%,平均为42.8±12%),第二组有14例低强度肺泡炎患者(支气管肺泡灌洗液中淋巴细胞少于28%,平均为13.3±6.5%)。两组在性别、胸部放射学分期或复发次数方面无差异。所有患者均进行了肺功能测试:用力肺活量(FVC)、第1秒用力呼气量(FEV1)、弥散功能(DLCO)以及静息和运动时动脉血氧分压。与低强度肺泡炎组相比,高强度肺泡炎组的FVC(p<0.01)和FEV1(p<0.05)显著更低,这表明高强度肺泡炎组患者的肺部疾病更严重,因此更常接受皮质类固醇治疗(69.2%)。对9例高强度肺泡炎患者和10例低强度肺泡炎患者进行了6个月的随访。高强度肺泡炎组的DLCO有统计学意义的改善(p<0.01),这可能是由于该组频繁使用皮质类固醇所致。高强度肺泡炎组的胸部X线片仅1例完全清晰,8例不完全清晰。(摘要截断于250字)

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