老年人结节病的临床分析

Clinical analysis of sarcoidosis in elderly patients

目的提高对老年人结节病的认识。方法回顾性分析临床确诊的13例老年结节病患者的临床资料。结果无症状查体时发现3例，首发症状为肺内和肺外表现者各5例。胸部影像学有8例呈不典型表现。8例经纤维支气管镜检查有5例呈炎症改变。5例肺泡灌洗液中淋巴细胞比例和CD。／CD。比值增高者各3例。7例通过活检确诊。13例经治疗后均不同程度缓解病情。结论老年人结节病l临床症状和影像学表现多种多样，常不典型，明确诊断需要结合检查结果综合分析。对有治疗指征的患者在密切监测下可给予皮质激素治疗。

Objective To improve the recognition of sarcoidosis in elderly patients. Methods Clinical data of 13 elderly patients with sarcoidosis were retrospectively analyzed. Results There were three cases without symptom and five cases with intra-pulmonary and extrwpulmonary manifestations respectively. Eight cases had atypical radiological appearances and five cases showed inflammatory changes through bronchofibercopy. There were three cases with increased percentage of lymphocytes and high ratio of CD4/CD8 in bronchoalveolar lavage fluid （BALF） respectively. Seven cases were diagnosed through biopsy. And the symptoms of all thirteen patients diminished after treatmeit. Conclusions The clinical symptom and radiological manifestation of sarcoidosis in elderly patients are varied and usually atypical. The diagnosis should be based on comprehensive analysis including clinical manifestation and examination. The elderly patients with indication of treatment can be given corticosteroid therapy with close clinical monitoring.