58例胸内结节病临床分析

Clinical analysis of 58 cases of patients with intrathoracic sarcoidosis

目的探讨胸内结节病的临床特点及诊断方法,提高对结节病的认识。方法回顾2001年来经组织病理学确诊的58例结节病患者的临床资料。结果呼吸道症状以咳嗽、胸闷最多,分别占56.6%(27/58)和32.8%(19/58)。血清血管紧张素转换酶阳性率为74.1%。经气管镜支气管黏膜活检和肺组织活检仍是最常用的活检方法,阳性率分别为65.7%和56.5%,淋巴结或皮下结节直接活检阳性率更高。结论胸内结节病临床表现多样无特异性,对可疑病例应尽可能作组织病理学检查明确诊断。

Objective To explore the clinical features and the diagnosis of intrathoracic sarcoidosis and in- crease the awareness of intrathoracic sarcoidosis. Methods Clinical materials from 58 consecutive patients with biop- sy-proven sarcoidosis since 2001 were retrospectively analyzed. Results The main symptoms of respiratory tract in- eluded cough （56.6%） and chest distress （32.8%）. 74.1% of the patients had high level of serum angiotensin convert- ing enzyme. The transbronchical mucosa biopsies （positive rate： 65.7%） and the transbronchial lung biopsies （positive rate： 56.5%） were the commonly used methods. Lymph node or subcutaneous nodule biopsy would receive higher pos- itive rate. Conclusion Since intrathoracie sareoidosis may not show specific clinical manifestation, pathological ex- amination should be made for the doubtful cases.