Bićanić V, Pavicić F, Richter D, Peros T, Popović-Grle S
Plucne Bolesti. 1989 Jan-Jun;41(1-2):18-21.
Restrictive disturbances of ventilation of various degree and disorders in diffusing capacity of the lung have been reported as the most frequent disorders in pulmonary sarcoidosis. Recently, however, several authors have found the obstructive disorders of ventilation being present as well, especially in the second stage of disease, and pointed out a possibility of the airways being affected very early at the onset of disease. Present study shows the results of functional tests carried out in 70 patients with histologically verified pulmonary sarcoidosis at all three stages of the disease (classification by Würm). All of them were nonsmokers, aged 20 to 55 years, and had no symptoms of chronic bronchitis, asthma or emphysema, either in case history or clinical findings. They included spirometry, flow-volume loop, body-plethysmography, blood gas analyses at rest and after exercise and pulmonary diffusing capacity for carbon monoxide obtained by single-breath method. Results from the study show the obstructive disorders of ventilation to be dominant in the early stage, while restrictive disturbances dominate in the third stage in pulmonary sarcoidosis. Diffusing capacity of the lung should be measured in the early stage of the disease as well as in those more advanced because of a possibility that interstitial space is being affected, although there is no visible damage on a radiograph. Measurement of pulmonary diffusing capacity together with radiological findings provide a highly valuable data which is of great importance in monitoring the dynamics of this disease.
据报道,不同程度的限制性通气障碍和肺弥散功能障碍是结节病中最常见的病症。然而,最近有几位作者发现,阻塞性通气障碍也存在,尤其是在疾病的第二阶段,并指出在疾病发作初期气道就很可能受到影响。本研究展示了对70例经组织学证实的结节病患者在疾病的所有三个阶段(按照维尔姆分类法)进行功能测试的结果。所有患者均为非吸烟者,年龄在20至55岁之间,无论是病史还是临床检查均无慢性支气管炎、哮喘或肺气肿症状。测试项目包括肺活量测定、流量-容积环、体容积描记法、静息及运动后血气分析以及通过单次呼吸法获得的肺一氧化碳弥散量。研究结果表明,在结节病早期,阻塞性通气障碍占主导,而在第三阶段,限制性通气障碍占主导。由于即使在X线片上没有可见损伤,但仍有可能存在间质空间受累的情况,因此在疾病早期以及病情更严重阶段均应测量肺弥散量。肺弥散量的测量结果与放射学检查结果相结合,可提供极具价值的数据,这对于监测该疾病的动态变化非常重要。