Chapelon C, Uzzan B, Piette J C, Jacques C, Coche E, Godeau P
Ann Med Interne (Paris). 1984;135(2):125-31.
The authors report the results of a retrospective cooperative study of 554 cases of sarcoidosis admitted to departments of internal medicine. The condition is more common in women (57 p. 100) than men (43 p. 100), but the onset is earlier in men. The clinical presentation is very variable and includes a wide variety of extra-thoracic localisations. "Guided" biopsy of early accessible lesions (skin, subcutaneous lymph nodes) is positive in 92 p. 100 of cases: the sensitivity of "blind" biopsy is less impressive, ranging from 49 to 69 p. 100 according to the tissue biopsied (bronchial mucosa, accessory salivary glands, liver). Alveolar lavage is positive in 65 p. 100, and angiotensin converting enzyme is positive in 58 p. 100 of untreated cases. There is a clear correlation between the results of these investigations and the radiological stage of the mediastino -pulmonary disease. Steroid therapy was instituted in 68 p. 100 of cases. The outcome with or without therapy was favourable in 82 p. 100 of cases, confirming the usually benign course of sarcoidosis when the heart is not involved.
作者报告了一项对554例内科住院结节病患者进行的回顾性合作研究结果。该病在女性中(占100例中的57例)比男性中(占100例中的43例)更常见,但男性发病更早。临床表现差异很大,包括多种胸外定位。对早期可触及病变(皮肤、皮下淋巴结)进行“引导式”活检,100例中有92例呈阳性:“盲目”活检的敏感性则较低,根据活检组织(支气管黏膜、副唾液腺、肝脏)不同,阳性率在49%至69%之间。肺泡灌洗100例中有65例呈阳性,未治疗病例中血管紧张素转换酶100例中有58例呈阳性。这些检查结果与纵隔-肺部疾病的放射学分期之间存在明显相关性。68%的病例采用了类固醇治疗。无论是否接受治疗,82%的病例预后良好,这证实了结节病在不涉及心脏时通常病程良性。