Baughman Robert P, Lower Elyse E
Division of Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio 45267, USA.
Semin Respir Crit Care Med. 2007 Feb;28(1):128-33. doi: 10.1055/s-2007-970338.
The treatment of sarcoidosis remains controversial. Corticosteroids remain the cornerstone of therapy, but immunosuppressive, cytotoxic, and immunomodulatory agents have emerged as viable therapeutic options for patients failing or experiencing adverse effects from corticosteroids. Published data are most extensive with methotrexate, but favorable responses have been noted with leflunomide, azathioprine, antimalarial and antimicrobial agents, and tumor necrosis factor-alpha inhibitors. This review focuses on these novel therapies for sarcoidosis, including indications for use, efficacy, toxicity, and monitoring.
结节病的治疗仍存在争议。皮质类固醇仍然是治疗的基石，但免疫抑制药、细胞毒性药和免疫调节药已成为对皮质类固醇治疗无效或出现不良反应的患者可行的治疗选择。关于甲氨蝶呤的已发表数据最为广泛，但来氟米特、硫唑嘌呤、抗疟药和抗菌药以及肿瘤坏死因子-α抑制剂也有良好疗效的报道。本综述重点关注这些结节病的新疗法，包括使用指征、疗效、毒性和监测。
