Baughman Robert P, Costabel Ulrich, du Bois Ronald M
Department of Medicine, University of Cincinnati Medical Center, Eden Avenue, Cincinnati, OH 45267-0565, USA.
Clin Chest Med. 2008 Sep;29(3):533-48, ix-x. doi: 10.1016/j.ccm.2008.03.012.
Not all patients who have sarcoidosis require treatment. For those who require treatment, the outcome of sarcoidosis can be considered conceptually in three broad, and at least partially overlapping, groupings: acute, chronic, and refractory. Although corticosteroids remain the initial drug for most patients who require therapy, several steroid-sparing alternatives have been found effective in treating many aspects of sarcoidosis. Methotrexate is most commonly used cytotoxic agent used for chronic disease, but azathioprine and leflunomide also have been shown to be useful. The tumor necrosis factor antibody infliximab has proved useful in treating refractory sarcoidosis. These various agents led to a treatment strategy for the various aspects of sarcoidosis.
并非所有结节病患者都需要治疗。对于那些需要治疗的患者，结节病的治疗结果在概念上可分为三大类，且至少部分重叠：急性、慢性和难治性。尽管皮质类固醇仍然是大多数需要治疗的患者的初始用药，但已发现几种替代药物在治疗结节病的许多方面有效，且可减少类固醇用量。甲氨蝶呤是治疗慢性病最常用的细胞毒性药物，但硫唑嘌呤和来氟米特也已证明有用。肿瘤坏死因子抗体英夫利昔单抗已被证明对治疗难治性结节病有效。这些不同的药物形成了针对结节病各个方面的治疗策略。
