Vital prognosis in intrathoracic sarcoidosis with special reference to pulmonary function and radiological stage.
Vital prognosis in intrathoracic sarcoidosis with special reference to pulmonary function and radiological stage.
复制标题
胸内结节病的重要预后特别参考肺功能和放射学分期。
DOI：
10.1183/09031936.93.06030349
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
J. Vestbo
中科院分区：
文献类型：
--
作者：
K. Viskum;J. Vestbo
在确诊入院后的中位数27年后，对254名胸腔内结节病患者进行了随访。所有患者都可以被追踪到。在随访结束时，没有额外的死亡率(观察到80例死亡，而预期为65.5例)。然而，在最初20年的随访中，我们看到了略高的死亡率。80例死亡病例中有33例与结节病有关。没有观察到过多的肺癌或淋巴瘤死亡病例。结节性红斑对生存没有预后意义。X线分期与生存期有关，第3期死亡率明显偏高。早期清除X线改变可提供良好的生命预后。生存与肺功能相关，1秒用力呼气量(FEV1)、FEV1/用力肺活量(FVC)指数和总肺活量(TLC)的关系达到统计学意义。在以年龄和性别作为协变量的多变量Cox回归模型中，同样的参数被发现是死亡率的显著预测因素。与FEV1和GT；80%预测的患者相比，FEV1和OR=50%预测的患者死亡风险增加4.2(95%可信区间1.8-9.6)。同样，与TLC和GT；80%预测的患者相比，TLC<；OR=80%预测的患者的死亡风险为2.6(1.5-4.5)。总而言之，在最初20年的随访中观察到了适度的超额死亡率。此外，诊断时的X射线分期和肺功能均影响胸腔内结节病患者的长期死亡率。
A follow-up of 254 patients with intrathoracic sarcoidosis has been carried out after a median of 27 yrs from the diagnostic admission. All patients could be traced. At the end of follow-up there was no excess mortality (80 deaths observed versus 65.5 expected). However, during the first 20 yrs of follow-up a slight excess mortality was seen. Thirty three out of the 80 deaths were related to sarcoidosis. No excess number of deaths from lung cancer or lymphoma was observed. Erythema nodosum was of no prognostic significance concerning survival. X-ray stage was related to survival with a significant excess mortality for stage 3. Early clearing of X-ray changes gave a favourable vital prognosis. Survival was related to lung function, and for forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) index and total lung capacity (TLC) this relationship reached levels of statistical significance. In multivariate Cox regression models, with age and sex entered as covariates, the same parameters were found to be significant predictors of mortality. Patients with FEV1 < or = 50% predicted had an increased mortality risk of 4.2 (95% confidence interval 1.8-9.6) when compared to patients with FEV1 > 80% predicted. Likewise, patients with TLC < or = 80% predicted had a mortality risk of 2.6 (1.5-4.5) when compared to patients with TLC > 80% predicted. In conclusion, a modest excess mortality was observed during the first 20 yrs of follow-up. Furthermore, both X-ray staging and lung function at the time of diagnosis influenced long-term mortality in patients with intrathoracic sarcoidosis.