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目的 分析老年人结节病的临床和病理资料 ,以探讨其诊断、治疗特点。 方法 按全国结节病诊断标准 ,对 196 5～ 1999年收治的 16例老年结节病患者予以确诊 ,并结合有关临床、实验室及组织学资料对其进行分析。 结果 16例老年结节病患者Ⅰ期 8例 ,Ⅱ期 6例 ,Ⅲ期 2例。临床表现呈多样性 ,误诊 8例 (5 0 % )。 16例分别随访 2～ 12年 ,Ⅱ、Ⅲ期患者治疗的 6例中 ,4例病情稳定 ,未治疗的 2例病情加重 ;Ⅰ期的 8例中 ,6例病情稳定 ;4例 (Ⅰ期 2例、Ⅱ期、Ⅲ期各 1例 )死于呼吸衰竭或心脑血管等疾病。 结论 重视老年结节病的早期诊断 ,严防漏诊和误诊 ,确诊后应严格掌握治疗指征 ,对Ⅱ、Ⅲ期结节病有治疗指征者 ,可给予皮质激素治疗。治疗中需长期连续观察 ,定期复查。
Objective To analyze the clinical and pathological data of sarcoidosis in the elderly in order to explore its diagnosis and treatment characteristics. Methods According to the diagnostic criteria of sarcoidosis in our country, 16 elderly patients with sarcoidosis admitted from 196 to 1999 were diagnosed and analyzed according to clinical, laboratory and histological data. Results 16 cases of elderly patients with sarcoidosis in stage Ⅰ in 8 cases, stage Ⅱ in 6 cases, stage Ⅲ in 2 cases. The clinical manifestations showed diversity, misdiagnosed in 8 cases (50%). Of the 16 patients who were followed up for 2 to 12 years, 4 of the 6 patients who were treated in stage II and III were in stable condition. Two of the 6 patients who were untreated were exacerbated. Of the 8 patients in stage I, 6 were stable and 4 were stable 2 cases, stage Ⅱ, stage Ⅲ in 1 case) died of respiratory failure or cardiovascular and cerebrovascular diseases. Conclusion The importance of early diagnosis of sarcoidosis in the elderly, prevent misdiagnosis and misdiagnosis, diagnosis should be strictly controlled indications for treatment of patients with stage Ⅱ, Ⅲ sarcoidosis indications, may be treated with corticosteroids. The need for long-term treatment of continuous observation, regular review.