Kornev B M, Moiseev S V
Ter Arkh. 1988;60(10):121-5.
Altogether 231 sarcoidosis patients were observed. Chest x-ray showed stage I in 116 patients, stage II in 111 patients. Corticosteroid therapy was provided to stage II patients only, with signs of alveolitis activity, for which assessment lung scintigraphy with 67Ga, investigation of bronchoalveolar rinse and determination of the blood angiotensin converting enzyme should be performed. Various extrapulmonary manifestations like hepatosplenomegaly, skin rash, cardiac arrhythmia and conduction disorder, urinary syndrome, etc., were revealed in 28 patients. The authors discussed variants of a course of lesions of the internal organs in sarcoidosis, difficulties of their diagnosis, and indications for steroid therapy. They also recommend a further study of the extrathoracic manifestations of sarcoidosis which frequently determine prognosis of this disease (first of all, cardiac, renal and nervous system affections), serve indicators of its activity (erythema nodosum, uveitis, parotitis, etc.) and present considerable diagnostic difficulties.
共观察了231例结节病患者。胸部X光显示,116例患者为I期,111例患者为II期。仅对有肺泡炎活动迹象的II期患者进行皮质类固醇治疗,为此应进行67Ga肺闪烁扫描、支气管肺泡灌洗检查及血血管紧张素转换酶测定。28例患者出现各种肺外表现,如肝脾肿大、皮疹、心律失常及传导障碍、泌尿系统综合征等。作者讨论了结节病内脏病变的病程变化、诊断困难及类固醇治疗的指征。他们还建议进一步研究结节病的胸外表现,这些表现常决定该病的预后(首先是心脏、肾脏和神经系统受累),是其活动的指标(结节性红斑、葡萄膜炎、腮腺炎等),且存在相当大的诊断困难。