肺结节病30例临床分析

目的探讨结节病的临床特点和诊断方法。方法回顾分析我院自1997年来经组织病理学确诊的30例结节病患者的临床资料。结果女性多于男性,男∶女为1∶2.0,平均发病年龄42.1岁。其中0期1例,Ⅰ期12例,Ⅱ期15例,Ⅲ期2例。呼吸道症状以咳嗽胸闷气促最多,分别占46.7%(14/30)、40.0%(12/30)和36.7%(11/30)。全身症状主要为乏力消瘦33.3%(10/30)和发热23.3%(7/30)。血清血管紧张素转换酶阳性率为70.0%。胸部X线、CT检查显示:肺门、纵隔淋巴结肿大伴或不伴两肺病变。经气管镜支气管黏膜活检和肺组织活检阳性率分别为72.7%和66.7%,纵隔镜活检阳性率100%。结论结节病易误诊,误诊率43.3%。结节病临床表现无特异性,对有肺门纵隔淋巴结肿大的可疑病例,应尽可能作组织病理学检查明确诊断。

Clinical Analysis of 30 Patients with Pulmonary Sarcoidosis

Objective To explore the clinical features and diagnosis of sarcoidosis. Methods Clinical materials of 30consecutive patients with biopsy proven sarcoidosis were retrospectively analyzed. Results There were more female patients than males and the ratio of males to females was 1 ： 2.0. The average age was 42.1 years. There were 1, 12, 15and 2cases in stage 0, Ⅰ, Ⅱ and Ⅲ respectively. The main symptoms of respiratory tract included cough （46.7%）, chest distress （40.0%） and anhelation （36.7%）. The main general symptoms included hypodynamia, emaciation and fever. Seventy percent of the patients had high levels of serum angiotensin convertingenzyme. The usual presentation of the chest X-ray and CT was hilar and （or） mediastinal lymphoadenopathy accompanied with diffusive lesion in bilateral lungs or not. The diagnosis was confirmed in 72.7% by the transbronchical mucosa biopsies and 66.7% by the transbronchial lung biopsies. The diagnosis was confirmed in 100% by lymph node biopsy through mediastinoscopy. Conclusion Sarcoidosis is easy to misdiagnosis, and the rate is 43.3%. No specific clinical manifestation may occur in the cases of sarcoidosis. Pathological examination should be made forthe prevention of missed diagnosis and misdiagnosis.