Jaroszewicz W, Krychniak W, Zych D
Z Erkr Atmungsorgane. 1977 Aug;149(2):184-6.
The examinations relate to 206 patients suffering from a bioptically confirmed sarcoidosis, observed during 1959-1974. The observation period amounted to 2-15 years. The indications of the corticosteroid-therapy ran as follows: 1. in cases of a lymph node sarcoidosis without respiratory disorders, after a 2 years' observation without a regression. 2. in cases with pulmonary alterations already after 3-6 months without a regression. 3. in all cases of an extended pulmonary sarcoidosis. In the first group the sarcoidosis developed spontaneously in 65.2%, after a treatment in 15.7%. In 19.1% there was an unfavourable course, even in treated cases (2.2%). In the second group there was a spontaneous regression in 35.5%, after a treatment in 57%. In 10% the sarcoidosis changed over into the chronic form. The treatment failed in about 3%. In the third group we did not observe any spontaneous regression, after the corticosteroid-therapy a regression appeared in 35.7%. The condition remained unchanged in 64.3%. Totally there was a spontaneous regressions in 44.2% of the patients. Good results after the corticosteroid-therapy were attained in 36.4%, and the rest of about 20% developed to irreversible forms of the disease.
这些检查涉及1959年至1974年期间观察到的206例经活检确诊为结节病的患者。观察期为2至15年。皮质类固醇治疗的指征如下:1. 对于无呼吸系统疾病的淋巴结结节病患者,在观察2年无病情缓解的情况下。2. 对于肺部有改变且3至6个月后仍无缓解的患者。3. 对于所有广泛性肺部结节病患者。在第一组中,结节病自发缓解的占65.2%,经治疗后缓解的占15.7%。在19.1%的病例中,即使是经治疗的病例(2.2%),病情发展也不利。在第二组中,自发缓解的占35.5%,经治疗后缓解的占57%。10%的结节病转变为慢性形式。治疗失败的约占3%。在第三组中,未观察到自发缓解情况,经皮质类固醇治疗后,35.7%出现缓解。病情无变化的占64.3%。总体而言,44.2%的患者出现自发缓解。经皮质类固醇治疗后取得良好效果的占36.4%,其余约20%发展为疾病的不可逆形式。