Objective To approach the influence of glucocorticoids on sarcoidosis and its prognosis. Methods Comparing the prognosis of 109 confirmed sarcoidosis patients involved in stage Ⅰ and Ⅱ either treated by glucocorticoids(GC) or not. Results Cough and chest distress were the primary complains in most of sarcoidosis patients. Symptoms and degree of pulmonary function damage of patients in stage Ⅱ were more significant than that in stage Ⅰ . There was no significant deviation in expression of SACE between two stage. The influence was similar on patients in stage Ⅰ if treated by GC or not but the self-healing rate was higher than that in stage Ⅱ (96.4% vs 76.9%, P ＜0.05). The effective rate of GC on patients in stage Ⅱ was higher than that of no therapy(87.0% vs 76.9%, P ＜0.05). Moreover, more patients had relapses in stage Ⅱ than that in stage Ⅰ (15.3% vs 6.0%, P＜0. 05). Conclusions It is not necessary to treat sarcoidosis in stage Ⅰ without symptoms. Different patients should be treated individualized. Reasonable therapy by GC would improve the prognosis.%目的 探讨糖皮质激素治疗结节病的疗效及对预后的影响.方法 回顾性分析经病理确诊的109例Ⅰ期和Ⅱ期结节病患者的临床资料,比较糖皮质激素治疗与否对预后的影响.结果 Ⅱ期结节病(59例)在临床症状和肺功能损害等方而均较Ⅰ期结节病(50例)明显,而在血清血管紧张素转换酶的表达方面差异无统计学意义.Ⅰ期结节病激素治疗与否对预后的影响差异无统计学意义,但自限率高于Ⅱ期结节病(96.4%比76.9%,P＜0.05).Ⅱ期结节病激素治疗有效率为87.0%,进展或复发率高于Ⅰ期结节病(15.3%比6.0%,P＜0.05).结论 无明显症状的Ⅰ期结节病可以无需激素治疗,施行个体化治疗方案,合理应用糖皮质激素治疗可以改善结节病的预后.
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