结节病误诊结核病18例分析

Analysis on 18 cases of Sarcoidosis Misdiagnosised as Tuberculosis

目的：本文对结节病误诊结核病18例进行分析，以提高对结节病认识。方法：通过临床观察，胸部x线，纤支镜活检，实验室检查分析。结果：造成误诊原因为①对结节病认识不足，②胸部x线易混淆，③病理检查取材困难，Keveim试剂来源限制，难以取得病理依据。结论：胸内结节病难以排除结核病时，可作SACE活性测定，纤支镜内肺活检及肺功能检查，以提高结节病诊断与结核病的鉴别。

To improve our diagnosis level of sarcoidosis. we analysed 18 patients with sarcoidosis, which had been misdiagnosed as tuberculosis. Methods: Observed their clinical symptoms and signs, chest X-rays,fiberoptic bronchiscopy biopsy and pathologic examination. Results: Following factors are responded to misdiagnosis:no deep understanding to sarcoidosis, similar X-ray signs between sarcoidosis and tuberculosis, difficulties in performing biopsy and lack of enough Keveim agent. Conclusion:Following methods should be adopted when we have difficulties in distinguishing sarcoidosis or tuberculosis: the determination of SACE activity, fiberoptic bronchiscopy biopsy and lung function examination.