肺结节病的临床研究

The clinical study of pulmonary sarcoidosis

目的 提高对结节病的认识。方法 回顾分析经病理确诊的结节病 2 1例患者的临床资料。结果 胸部结节病多数有双侧肺门阴影对称性增大占 (71% )。 6 2 .5 %的患者支气管肺泡灌洗液中 CD4/CD8>3.5。 90 .4%的患者 PPD为阴性。纤支镜支气管粘膜和肺活检及胸部小切口开胸肺活检病理确诊阳性率分别为 80 %和 10 0 %。结论 胸部 X线 ,PPD及支气管肺泡灌洗液 CD4/CD8检查对诊断结节病十分重要。经纤支镜支气管粘膜和肺活检和胸部小切口开胸肺活检简便易行 ,创伤小 ,阳性率高的方法 。

To increase the awareness of intrathoracic sarcoidosis.Method The clinical data of 21 cases with intrathoracic sarcoidosis confirmed by pathology were reviewed.Results The bilateral pulmonary hilar lymph node enlargement on chest radiographs was found in 71% of the patients. In 62.5% of the cases,bronchoalveolary lavage(BAL) showed lymphocytosis combined with a CD 4/CD 8 ratio>3.5%.90.4% of the patients had negative PPD.The diagnosis was confirmed in 80% of the bronchial mucosa biopsies and transbranchial lung biopsies(TBLB) through fiberotic bronchospy and 100% of the transthoracic lung biopsies with small thoracotomy.Conclusion Chest X ray, PPD and CD 4/CD 8 ratio in BAL are helpful in the diagnosis for sarcoidosis.The bronchial mucosa biopsies of TBLB and the transthoracic lung biopsies with small thoracotomy are convenient dicgvostic methods that have less invasive values in the diagnosis of intrathoracic sarcoidosis,especially for undetermined cases.