Kirsten D
Zentrum für Pneumologie und Thoraxchirurgie, LVA Freie und Hansestadt Hamburg, Grosshansdorf.
Pneumologie. 1995 Jun;49(6):378-82.
In 1992, we performed a questionnaire study in patients, who are organized in the German Sarcoidosis Self-help group. The aim of our study was to analyze the state of diagnosis and therapy of sarcoidosis. In addition, patients were asked for their proposals to the physicians. We obtained valid answers from 651 patients. A high percentage of incorrect first diagnosis (in 37% as tuberculosis) seemed to be dependent on the insufficient use of bronchologic techniques and on the fact that in 19% of patients diagnosis was established only by chest x-ray. The diagnostic delay was estimated by the difference between the occurrence of the first clinical symptoms or x-ray findings and the final diagnosis of sarcoidosis and was on average (+/- SD) 2 +/- 5 years. Extrapulmonary manifestations were reported in 47% but histologically proven only in 30% of patients. 95% of treated patients had cortisone therapy, the median duration of therapy was 3.9 years. 19% of the patients underwent so-called alternative therapy concept (mostly immunostimulation) after lack of sufficient effect of cortisone treatment on symptoms and/or radiologic features. 12% of the patients were not treated at all. Familiar associations of sarcoidosis were reported by 49 patients. The patients asked for more research, more exchange of information, better education of students and physicians on this field and more interdisciplinary contacts.
1992年,我们对德国结节病自助组织中的患者进行了一项问卷调查研究。我们研究的目的是分析结节病的诊断和治疗状况。此外,还询问了患者对医生的建议。我们从651名患者那里获得了有效答案。较高比例的初次诊断错误(37%被误诊为肺结核)似乎取决于支气管镜检查技术使用不足,以及19%的患者仅通过胸部X光片确诊这一事实。诊断延迟通过首次临床症状或X光检查结果出现与结节病最终诊断之间的时间差来估算,平均为(±标准差)2±5年。47%的患者有肺外表现,但经组织学证实的仅占30%。95%接受治疗的患者采用了皮质类固醇治疗,治疗的中位持续时间为3.9年。19%的患者在皮质类固醇治疗对症状和/或放射学特征效果不佳后,采用了所谓的替代治疗方案(主要是免疫刺激)。12%的患者根本未接受治疗。49名患者报告了结节病的家族关联。患者们要求进行更多研究、更多信息交流、在该领域对学生和医生进行更好的教育以及更多的跨学科联系。