结节病专题 课件.pptVIP

Results (DLCO and Cst in all patients): Results (DLCO and Cst in non-restrictives): Results (DLCO and Cst in non-restrictives): Results (FEV1/VC and MMEF in all patients): Airflow limitation (lowered FEV1/VC and/or MMEF in all patients): Airflow limitation (lowered FEV1/VC and/or MMEF in ever and never smokers): █ MMEF only, █ MMEF and FEV1/VC, █ FEV1/VC only, █ no airflow limitation Airflow limitation (lowered FEV1/VC and/or MMEF in all patients and acc. to smoking status): 19% 28% 23% Airflow limitation (lowered FEV1/VC and/or MMEF in all patients and acc. to stage): █ MMEF only, █ MMEF and FEV1/VC, █ FEV1/VC only, █ no airflow limitation 17% 31% 23% 33% Restrictive pattern expressed as lowered lung volumes indices was observed only in 7.2% of patients Lung parenchyma involvement pronounced as diminished Cst and/or DLCO was detected in 42% of non-restrictive patients Airflow limitation (reduced FEV1/VC and/or MMEF) was found in approximately 23% of patients regardless of they were smokers or not In 42% of cases lung function indices were in normal range Results: Summary smokers: ever never Expected restrictive pattern of ventilatory impairment is uncommon, especially in early stages of saroidosis, while Cst and DLCO reduction is more sensitive in revealing lung function disturbances. Airflow limitation (↓FEV1/VC and/or ↓MMEF) is a frequent phenomenon even in never smokers sarcoidosis patients. Conclusions: FREQUENCY OF INCREASED sACE LEVELS IN VARIOUS DISEASES Beryllium disease 75% Sarcoidosis 57% Silicosis 42% Leprosy 34% Primary biliary cirrhosis 27% Histoplasmosis 16% Extrinsic allergic alveolitis 14% Asbestosis 11% Tuberculosis 4% Hodgkins disease 3% 诊断标准 1.胸片示双肺门及纵隔淋巴结肿大（偶见单侧），伴或不伴有肺内网状、结节状、片状阴影。 2. 组织活检证实或符合结节病。 3. Kveim试验阳性反应。 4. sACE升高。 5. 5 IU PPD试验阴性或弱阳性反应。 6. 高血钙、高尿钙、AKP增高、Ig增高、67镓扫描阳性、BALF中TLC及CD4/CD8升高。 具有1，2或1，3条者可诊断为结节病。 第4、5、6条为重要的参考指标。注意综合诊断、动态观察。 结节病的治疗