胸内结节病60例临床分析

Clinical study on intrathoracic sarcoidosis:a report of 60 cases

目的 探讨结节病的临床特点及诊断方法。方法 对 1992 - 0 1～ 2 0 0 3- 0 4期间上海市胸科医院住院的经病理证实的结节病患者 6 0例作一回顾性分析 ,总结临床特点并对不同的诊断方法进行评价。结果 结节病主要累及器官以肺门及纵隔淋巴结最常见。肺功能主要为限制性通气障碍及弥散功能下降。纤支镜支气管黏膜活检和经支气管镜肺活检 (TBLB)阳性率分别为 80 %和 77 8% ,浅表淋巴结和皮肤结节活检阳性率分别是87%和 87 5 %。结论 该病临床表现非特异性。外周淋巴结活检 ,纤支镜支气管黏膜活检 ,TBLB ,简便易行 ,阳性率高 ,创伤性小 ,对结节病的诊断有较高的临床实用价值。

Objective To explore the clinical features and diagnosis of pulmonary sarcoidosis.Methods The data of 60 cases of pulmonary sarcoidosis confirmed by pathology was reviewed to determine the clinical features and the value in the diagnosis of sarcoidosis.Results The main clinical manifestations of sarcoidosis included bilateral hilar and mediastinal lymphadenopathy.The results of lung function tests showed that these patients had restrictive ventilating obstacles with decreased DLCO.The diagnosis was confirmed in 80% of the bronchial mucosa biopsies and 77.8% of the transbranchial lung biopsies through fiberotic bronchoscopy,87% of the biopsies of peripheral lymphnodes and 87.5% of the subskin nodes biopsies.Conclusion Nonspecific constitutional symptoms may occur in the cases of sarcoidosis.To the diagnosis of intrathoracic sarcoidosis,peripheral lymph nodes biopsies,the bronchical mucosa biopsies and TBLB are the convenient methods with highly definite diagnosis rate and microinvasion in clinical practice.