First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Department of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan.
Respirology. 2017 Nov;22(8):1604-1608. doi: 10.1111/resp.13105. Epub 2017 Jul 16.
A number of previous studies have reported on the rate of resolution of pulmonary sarcoidosis and its associated factors. However, most of the studies were conducted several decades ago and no similar surveys have been conducted in recent years. The aim of this study was to evaluate the rate of resolution of pulmonary sarcoidosis and its related factors in recently diagnosed patients, and to compare the results with those from previous studies.
This study included 306 patients who had been newly diagnosed with pulmonary sarcoidosis between 2000 and 2009 in Sapporo, Japan. Chest radiographical findings were assessed at the initial visit and at the 2- or 5-year observation points. The rates of resolution on chest radiographs and the association with clinical manifestations were evaluated.
The resolution rates were 17.9% at the 2-year and 29.9% at the 5-year observation point. These rates were lower than those reported in the earlier surveys. Younger subjects (aged <40 years) showed resolution more often (P < 0.05). The absence of extra-pulmonary organ involvement was associated with resolution at 5 years (P < 0.05).
The clinical course of pulmonary sarcoidosis may be changing, showing a tendency not to resolve. At least in part, this may be due to the ageing of the Japanese population.
许多先前的研究都报道了肺结节病的缓解率及其相关因素。然而,大多数研究是几十年前进行的,近年来没有类似的调查。本研究旨在评估最近诊断为肺结节病患者的缓解率及其相关因素,并与以往研究的结果进行比较。
本研究纳入了 2000 年至 2009 年间在日本札幌新诊断为肺结节病的 306 例患者。在初诊时和 2 年或 5 年观察点评估胸部影像学表现。评估胸部 X 线片的缓解率及其与临床表现的关系。
2 年和 5 年观察点的缓解率分别为 17.9%和 29.9%。这些比率低于早期调查的报告。年轻患者(年龄 <40 岁)更常出现缓解(P <0.05)。无肺外器官受累与 5 年时的缓解相关(P <0.05)。
肺结节病的临床病程可能正在发生变化,表现出不易缓解的趋势。至少在一定程度上,这可能是由于日本人口老龄化所致。