Kobayashi Hideo, Kanoh Soichiro, Motoyoshi Kazuo, Ozeki Yuichi
Third Department of Internal Medicine, National Defense Medical College.
Nihon Kokyuki Gakkai Zasshi. 2007 Aug;45(8):598-603.
It is not well understood what kind of histologic resolution is obtained with corticosteroid medication in sarcoidosis, or how we are able to judge cure in that disease. We examined the cases of sarcoidosis who were under steroid medication and received lobectomy and lymphadenectomy for combined lung cancer. Steroid treatment had been introduced for the relief of visual disturbance, not for the pulmonary lesion. Administration of corticosteroid improves clinical, laboratory, bronchoalveolar lavage and radiological findings, but it is difficult to make histological granulomatous inflammation completely disappear. Improvement of radiological and clinical problems in sarcoidosis is not the same as complete cure in patients with steroid-treated sarcoidosis.
目前尚不清楚在结节病中使用皮质类固醇药物能获得何种组织学缓解,也不清楚我们如何判断该疾病已治愈。我们检查了接受类固醇药物治疗且因合并肺癌接受肺叶切除术和淋巴结切除术的结节病病例。使用类固醇治疗是为了缓解视力障碍,而非针对肺部病变。皮质类固醇的使用改善了临床、实验室、支气管肺泡灌洗和影像学检查结果,但很难使组织学上的肉芽肿性炎症完全消失。结节病影像学和临床问题的改善与接受类固醇治疗的结节病患者的完全治愈并不相同。