Hoyle C, Smyllie H, Leak D
Thorax. 1967 Nov;22(6):519-24. doi: 10.1136/thx.22.6.519.
The results are described of prolonged corticosteroid treatment in 52 patients with pulmonary sarcoidosis observed for a mean duration of 10·5 years from diagnosis. Twenty of the patients were treated for less than one year, the remainder for a mean of five years. The mean length of observation after discontinuing treatment was 5·5 years. Selection of patients for treatment was based on (1) evidence from radiographic observation, even for two years or more, that the disease was progressive so that spontaneous remission was improbable; and (2) evidence of disturbed lung function, especially the onset of dyspnoea or an impaired diffusing capacity. Treatment, conveniently with prednisone at a maintenance dose of about 15 mg. daily, should be continued for at least a year and often for much longer until withdrawal is not followed by radiographic relapse. Such treatment does not increase the chance of a complete remission even when given at an early stage of the disease; and relief of dyspnoea is unpredictable and seldom considerable. But prolonged treatment will halt progressive lung destruction and appears to curb the eventual mortality.
本文描述了52例肺结节病患者长期使用皮质类固醇治疗的结果，自诊断起平均观察时长为10.5年。其中20例患者治疗时间不足一年，其余患者平均治疗时间为五年。停药后的平均观察时长为5.5年。选择患者进行治疗的依据为：（1）影像学观察证据，即使观察两年或更长时间，显示疾病呈进行性发展，不太可能自发缓解；（2）肺功能紊乱的证据，尤其是出现呼吸困难或弥散功能受损。治疗时，方便起见可使用泼尼松，维持剂量约为每日15毫克，应持续至少一年，通常持续更长时间，直至停药后影像学无复发。即使在疾病早期进行这种治疗，也不会增加完全缓解的几率；呼吸困难的缓解情况不可预测，且很少显著。但长期治疗将阻止肺部进行性破坏，并似乎能降低最终死亡率。
