Vestbo J, Langer S W, Iversen E T, Viskum K
Lungemedicinsk Afdeling P, Bispebjerg Hospital, København.
Ugeskr Laeger. 1995 May 15;157(20):2848-50.
Frequency and prognostic importance of extrapulmonary manifestations have been examined in 254 patients with intrathoracic sarcoidosis. A follow-up was carried out after a median of 27 years from diagnosis. All patients could be traced. Extrapulmonary manifestations were found in 119 patients (47%), mostly occurring within the first years after diagnosis of intrathoracic sarcoidosis; skin manifestations were most frequently seen. ECG-abnormalities were found in 35 patients (14%); in 17 cases in the form of sinus tachycardia. No excess mortality was found (80 deaths observed versus 66 expected). The causes of death were related to sarcoidosis in 41%. Only tachycardia was associated with an unfavourable prognosis and this association vanished after adjusting for decreased lung function. None of the other extrapulmonary manifestations were associated with an unfavourable vital prognosis. Erythema nodosum was of no prognostic significance concerning survival. In conclusion, extrapulmonary manifestations are frequent in patients with intrathoracic sarcoidosis but do not influence vital prognosis.
对254例胸内结节病患者的肺外表现频率及其预后重要性进行了研究。自诊断起中位数27年后进行了随访。所有患者均可追踪到。119例患者(47%)出现肺外表现,大多发生在胸内结节病诊断后的头几年;皮肤表现最为常见。35例患者(14%)发现心电图异常;17例为窦性心动过速。未发现超额死亡率(观察到80例死亡,预期66例)。41%的死亡原因与结节病有关。只有心动过速与不良预后相关,在调整肺功能下降因素后这种关联消失。其他肺外表现均与不良生存预后无关。结节性红斑对生存无预后意义。总之,胸内结节病患者肺外表现常见,但不影响生存预后。