Brugger E, Schmidt M, Kulke H
Med Klin. 1979 Oct 26;74(43):1593-7.
With only a few exceptions, in sarcoidosis the lung is virtually always, the liver mostly and the spleen only occasionally involved. Therefore, thorax-X-ray is the most important screening procedure. Histological verification by laparoscopy, bronchoscopy (transbronchial lung biopsy and bronchial mucosa biopsy) or mediastinoscopy is essential. In order to decide the therapeutic regimen, particularly the use of corticosteroids, the staging according to Wurm seems less suitable than pulmonary function testing (pneumotachograph, plethysmograph, CO-transfer, compliance). Futher clinical trials will have to find out, whether enzyme analysis (ACE) is apt to monitor progression of disease or to diagnose sarcoidosis in clinical routine use.
除少数例外情况外,结节病几乎总是累及肺部,大多累及肝脏,仅偶尔累及脾脏。因此,胸部X线检查是最重要的筛查方法。通过腹腔镜检查、支气管镜检查(经支气管肺活检和支气管黏膜活检)或纵隔镜检查进行组织学确诊至关重要。为了确定治疗方案,特别是皮质类固醇的使用,根据武尔姆分期似乎不如肺功能测试(呼吸流速仪、体积描记器、一氧化碳转运、顺应性)合适。进一步的临床试验必须弄清楚,酶分析(血管紧张素转换酶)是否适合在临床常规应用中监测疾病进展或诊断结节病。