Johns C J, Zachary J B, MacGregor M I, Curtis J L, Scott P P, Terry P B
Trans Am Clin Climatol Assoc. 1983;94:173-81.
Although spontaneous remissions are frequent in sarcoidosis, chronic persistent disabling disease is also observed. This feature seems more frequent and more severe in black patients, as has been previously reported (10). The more extensive and severe the initial disease manifestations, the more likely it is that the disease will continue. Corticosteroids are usually beneficial and complications are infrequent. Delayed or interrupted treatment seems to allow progression or irreversible disease or both. Patient compliance is an obvious important factor. Relapses are frequent as treatment is withdrawn but are usually at least partially reversible. Some deterioration is observed with repeated relapses. Low dose daily prednisone (5-15 mg) seems to prevent relapses. Patient compliance is facilitated with daily treatment rather than alternate day therapy. Prolonged treatment for 10 to 15 or more years is often required. Chloroquine is particularly helpful in skin and mucosal disease. The necessity for long-term thoughtful management is obvious.
尽管结节病常出现自发缓解，但也会观察到慢性持续性致残疾病。正如先前报道的那样（10），这一特征在黑人患者中似乎更为常见且更为严重。初始疾病表现越广泛、越严重，疾病持续的可能性就越大。皮质类固醇通常有益且并发症罕见。延迟或中断治疗似乎会导致疾病进展或出现不可逆病变，或两者皆有。患者的依从性显然是一个重要因素。随着治疗的撤减，复发很常见，但通常至少部分是可逆的。反复复发会观察到一些病情恶化。每日服用低剂量泼尼松（5 - 15毫克）似乎可预防复发。每日治疗而非隔日治疗有助于提高患者的依从性。通常需要进行长达10至15年或更长时间的治疗。氯喹对皮肤和黏膜疾病特别有帮助。显然需要进行长期的精心管理。
