Mañá J, Salazar A, Manresa F
Department of Medicine, Hospital de Bellvitge, University of Barcelona, Spain.
Respiration. 1994;61(4):219-25. doi: 10.1159/000196341.
The prognosis of sarcoidosis is difficult to establish and it depends mainly on the persistence of activity over time and the degree of functional impairment of the involved organs. The aim of this study was to identify factors predicting persistence of disease activity at diagnosis. In a 14-year period (1974-1987), 209 patients were diagnosed with sarcoidosis at Bellvitge Hospital, a 1,000-bed teaching institution in Barcelona, Spain. One hundred ninety-three patients were followed up and included in the study. Clinical and radiological data were collected at diagnosis and a definition of disease activity was established. A Cox proportional-hazards regression model identified the following variables as independently influencing the persistence of activity: absence of erythema nodosum (risk ratio, RR = 2.37; 95% confidence interval, CI: 1.54-3.66), pulmonary infiltrates in chest x-ray (RR = 1.89, 95% CI: 1.28-2.8), splenomegaly (RR = 3.67, 95% CI: 1.46-9.23), age > or = 40 years (RR = 1.01, 95% CI: 1.006-1.03), and absence of lymphadenopathy in chest x-ray (RR = 2.26, 95% CI: 1.08-4.77). We suggest that the identification of factors predicting persistence of sarcoidosis activity at diagnosis may help to establish the prognosis of the disease and therefore improve the therapeutic approach.
结节病的预后难以确定，主要取决于疾病活动随时间的持续情况以及受累器官的功能损害程度。本研究的目的是确定在诊断时预测疾病活动持续存在的因素。在14年期间（1974 - 1987年），西班牙巴塞罗那一家拥有1000张床位的教学机构贝尔维特奇医院诊断出209例结节病患者。193例患者接受了随访并纳入研究。在诊断时收集了临床和放射学数据，并确定了疾病活动的定义。Cox比例风险回归模型确定以下变量独立影响活动的持续存在：无结节性红斑（风险比，RR = 2.37；95%置信区间，CI：1.54 - 3.66）、胸部X线显示肺部浸润（RR = 1.89，95% CI：1.28 - 2.8）、脾肿大（RR = 3.67，95% CI：1.46 - 9.23）、年龄≥40岁（RR = 1.01，95% CI：1.006 - 1.03）以及胸部X线无淋巴结病（RR = 2.26，95% CI：1.08 - 4.77）。我们认为，确定诊断时预测结节病活动持续存在的因素可能有助于确定疾病的预后，从而改进治疗方法。
