Sharma S K, Khanna M, Sharma S, Srivastava L M, Verma K, Khilnani G C, Pande J N
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Indian J Med Res. 1995 May;101:207-12.
Effect of daily oral prednisolone treatment was studied in 29 patients with pulmonary sarcoidosis. Twenty normal control subjects were also studied. Pretreatment absolute lymphocyte counts and proportion of lymphocytes in peripheral blood were significantly lower in patients with sarcoidosis as compared to normal controls. Total cell count and the proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid were significantly higher in sarcoidosis. The proportion of CD3+ and CD4+ was significantly lower in peripheral blood and higher in BAL fluid in patients with sarcoidosis. Immunoglobulins (IgG, A and M) and complements (C3, C4 and CH50) were significantly higher both in peripheral blood and BAL fluid. Patients with sarcoidosis were treated with daily oral prednisolone (30 mg/day). Repeat studies were performed after an interval of 4-6 months in 20 patients with sarcoidosis. A significant increase in absolute lymphocyte counts in peripheral blood and decrease in the proportion of lymphocytes in BAL fluid occurred with prednisolone treatment. Proportion of CD3+, CD4+ and B cells increased in peripheral blood and decreased in BAL fluid. Complement and immunoglobulin levels revealed a significant reduction in peripheral blood and BAL fluid. It is concluded that patients with sarcoidosis have peripheral blood lymphopaenia and lymphocytic alveolitis. They have increased levels of complement and immunoglobulins both in the peripheral blood and BAL fluid. All these abnormalities show significant improvement with prednisolone treatment.
对29例肺结节病患者进行了每日口服泼尼松龙治疗的效果研究。还对20名正常对照者进行了研究。与正常对照相比，结节病患者治疗前外周血绝对淋巴细胞计数和淋巴细胞比例显著降低。结节病患者支气管肺泡灌洗（BAL）液中的总细胞计数和淋巴细胞比例显著更高。结节病患者外周血中CD3 +和CD4 +的比例显著更低，而BAL液中则更高。免疫球蛋白（IgG、A和M）以及补体（C3、C4和CH50）在外周血和BAL液中均显著更高。结节病患者接受每日口服泼尼松龙（30毫克/天）治疗。20例结节病患者在间隔4 - 6个月后进行了重复研究。泼尼松龙治疗后，外周血绝对淋巴细胞计数显著增加，BAL液中淋巴细胞比例降低。外周血中CD3 +、CD4 +和B细胞的比例增加，BAL液中则降低。补体和免疫球蛋白水平在外周血和BAL液中均显著降低。结论是，结节病患者存在外周血淋巴细胞减少和淋巴细胞性肺泡炎。他们外周血和BAL液中的补体和免疫球蛋白水平均升高。所有这些异常在泼尼松龙治疗后均有显著改善。
