84例肺结节病临床特征分析.pdfVIP

中国临床医学 2007年12月 第 14卷 第6期 Clinical Medical Journal of China，2007．Vo1．14，No．6 797 · 论著 · 84例肺结节病临床特征分析 张维杰 祝 蓉 贾友明 白春学 摘要 目的：探讨肺结节病的临床特点及诊治方法。方法：分析84例肺结节病患者的临床资料。结果：本组病例有以下临床 特征：(1)以中老年女性患者为主，平均年龄48．26岁；(2)症状多样性。胸部x线检查是早期诊断的重要手段，支气管肺泡灌 洗液细胞分类对诊断有帮助；(3)确诊依赖组织病理学。经纤支镜粘膜活检及经纵隔镜淋巴结活检诊断阳性率较高。结论：肺 结节病临床表现多样，糖皮质激素治疗有一定疗效．但应采取个体化疗法．必要时加用其它免疫抑制剂。 关键词 结节病； 肺； 临床表现； 治疗 中图分类号 R563．9 文献标识码 A Clinical Features Analysis of 84 Patients with Sarcoidosis ZHANG Weij ZHURong JIA Youming BAI Chull,Tue Department of’Respiratory Medicine，Zhongshan Hospital，Fudan Universiry，Shang hai 200032 Abstract Objective：To discuss the clinical features and therapy of sarcoidosis．Methods：A retrospective analysis was used in 84 patients with sarcoidosis diagnosed in the last 6 years．Results：Sarcoidosis had several clinical features as follow：(1)Most of the patients were middle and elderly female．(2)Respiratory symptom was mild and X—ray test of chest was the major way tO di— agnose the disease at early stage．The percent of lymphocytes in broncho—alveolar lavage fluid(BAI F)was valuable for diagno— sis．(3)In all approaches of biopsy，the way through fibrobronchoscopy or mediastinoscopy was more efficient，and diagnosis was depended on hist0pathology．Conclusion：Sarcoidosis was likely tO he misdiagnosed，and glucocorticoid was the effective drug for therapy．Each patient should he treated individually．If necessary，other imnmnosuppressors should he added． Key Words Sarcoidosis； Lung； Clinical analysis； Therapy 本文回顾性分析84例肺结节病患者的临床资 包积液3例。(2)1I期：双侧肺门淋巴结肿大伴肺浸 料。 润，共1 9例，合并胸腔积液3例。(3)11I期：仅有肺 1 资料与方法 间质浸润而无肺门淋巴结肿大，共5例。合并胸腔 1．1 研究对象 复旦大学附属中山医院1999年4 积液1例。(4)Ⅳ期：进行性肺间质纤维化为主的病 月一2()()5年6月问经过病理检查证实的84例肺结 变，可伴有肺大泡或囊性支气管扩张，共7例；合并 节病患者，其中70例