Department of Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio.
Semin Respir Crit Care Med. 2014 Jun;35(3):391-406. doi: 10.1055/s-0034-1376401. Epub 2014 Jul 9.
For treatment of sarcoidosis, one should develop a long-term management plan. Factors to be considered include the organ involvement and severity of symptoms. Different organ manifestations may require different treatments. Intensity of treatment is usually based on severity of disease or potential for organ failure or death. Glucocorticoids are quite effective as initial therapy for most forms of sarcoidosis. However, the toxicity associated with long-term treatment often leads to the use of alternative treatments. These include cytotoxic agents such as methotrexate, biologic agents such as the antitumor necrosis factor antibody infliximab, and other anti-inflammatory drugs such as hydroxychloroquine. In some cases, anti-inflammatory drugs may not help. Examples include pulmonary hypertension and fibrosis.
对于结节病的治疗，应制定长期管理计划。需要考虑的因素包括器官受累和症状严重程度。不同的器官表现可能需要不同的治疗方法。治疗强度通常基于疾病的严重程度或发生器官衰竭或死亡的风险。糖皮质激素是大多数类型结节病初始治疗的有效药物。然而，长期治疗相关的毒性常导致需要使用替代治疗。这些治疗包括细胞毒性药物如甲氨蝶呤、生物制剂如抗肿瘤坏死因子抗体英夫利昔单抗，以及其他抗炎药物如羟氯喹。在某些情况下，抗炎药物可能无效。例如肺动脉高压和纤维化。
