结节病有无肺外侵犯的临床特征对比分析

Contrast analysis of clinical features of sarcoidosis with or without extrapulmonary involvement

目的研究胸部结节病肺外侵犯的临床特征。方法收集结节病患者130例,分为有肺外侵犯组(A组,n=73)和无肺外侵犯组(B组,n=57),对两组患者的临床资料包括性别、年龄、症状、实验室检查、治疗等情况进行对比分析。结果结节病有肺外侵犯组受累部位广泛,且确诊周期长、误诊率高,A组发热比例、血清血管紧张素转换酶(sACE)、血沉、激素治疗率均比B组高,分别为发热26.0%(17/73)vs 11.8%(6/57);sACE(59.2±17.9)U/Lvs(45.6±13.4)U/L;血沉(30.3±14.5)mm/1hvs(22.5±10.6)mm/1h,激素治疗率34.2%(25/73)vs 15.8%(9/57)(P<0.05或<0.01),两组在性别、年龄、影像学分期、激素有效率、自行缓解率上差异无统计学意义。结论结节病肺外侵犯很常见,有无肺外侵犯者临床特征有所不同,判断结节病肺外侵犯情况有助于指导是否采用激素治疗。

Objective To study the clinical features of sarcoidosis with extrapulmonary involvement. Methods A total of 130 newly diagnosed sarcoidosis cases were divided into extrapulmonary involvement group（group A, n = 73） and without extrapulmonary involvement group （group B, n = 57）. The clinical data of two groups including gender, age, symptom, assistant examination and treatment were compared. Results Extrapulmonary sarcoidosis involved many Organs and cost longer time for diagnosis and held higher misdiagnosis rates. The incidence of fever, serum angiotensin-converting enzyme （sACE）, level of erythrocyte sedimei^tation rate （ESR） and eorticosteroid treatment rate in group A were significantly higher than those of group B, fever 26.0% （17/73） vs 11.8% （6/57） sACE（59.2±17.9） U/L vs （45.6±13.4） U/L;ESR（30.3±14.5） mm/1 h vs （22.5±10.6） mm/1h, eorticosteroid treatment rate 34.2% （25/73） vs 15.8%A （9/57） （ P 〈0, 05 or 〈0.01）. There were no differences in gender, age, imaging stage, eorticosteroid effective rate and spontaneous remission rate between two groups. Conclusion Extrapulmonary involvement was frequent in sarcoidosis. There were some differences in clinical features between the sarcoidosis with and without extrapulmonary involvement. The estimate of extrapulmonary involvement would be useful to guide corticosteroid treatment.