Outcome in sarcoidosis - The relationship of relapse to corticosteroid therapy
Outcome in sarcoidosis - The relationship of relapse to corticosteroid therapy
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DOI：
10.1378/chest.111.3.623
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发表时间：
1997-03-01
期刊：
影响因子：
9.6
通讯作者：
Patrick, H
中科院分区：
文献类型：
--
作者：
Gottlieb, JE;Israel, HL;Patrick, H
研究目的：确定经皮质类固醇治疗的结节病患者在临床稳定期超过1个月后复发的人口统计学、临床和影像学特征，并将这些特征与未接受治疗的结节病患者进行比较。设计：历史、同期和前瞻性、非随机、观察性研究。一家大学城医院的门诊结节病门诊。患者：在4年的日历期内，337例结节病患者前瞻性登记。118例患者被分配到一个自发缓解组时，症状解决没有治疗，103名被分配到一个诱导缓解组时，症状解决后，皮质类固醇治疗和成功停药。在116名被分配到枸橼酸组的患者中，由于症状严重或缺乏依从性，治疗不能停止1个月或更长时间。我们将复发定义为症状的复发，其严重程度足以保证皮质类固醇治疗，缓解后未治疗持续超过1个月。干预：被判定为有足够的症状而无法在不进行治疗的情况下进行观察或对局部或吸入性皮质类固醇或非甾体抗-用全身性皮质类固醇以每天20 mg泼尼松的目标剂量治疗炎症剂1年。测量和结果：我们观察到诱导缓解组的复发率为74%，而自发缓解组的复发率仅为8%（p
Study objective: To determine the demographic, clinical and radiographic characteristics of corticosteroid-treated patients with sarcoidosis who developed relapse following a period of clinical stability lasting longer than 1 month, and to compare these characteristics with those of a group of patients with sarcoidosis who were not treated.Design: Historic, concurrent and prospective, nonrandomized, observational study.Setting: Ambulatory sarcoidosis clinic in a university city hospital.Patients: Over a 4-year calendar period, 337 patients with sarcoidosis were prospectively enrolled in a registry. One hundred eighteen patients were assigned to a spontaneous remission group when symptoms resolved without treatment, and 103 were assigned to an induced remission group when symptoms resolved following corticosteroid therapy and successful discontinuation. In 116 patients assigned to a recalcitrant group, therapy could not be stopped for 1 month or more owing to severity of symptoms or lack of compliance. We defined relapse as a recurrence of symptoms of sufficient severity to warrant treatment with corticosteroids, following a remission without treatment lasting greater than 1 month.Intervention: Patients who were judged to be sufficiently symptomatic to preclude observation without treatment or who failed to respond to conservative treatment with topical or inhaled corticosteroids or nonsteroidal anti-inflammatory agents were treated with systemic corticosteroids at a target dose of 20 mg prednisone per day for 1 year.Measurements and results: We observed a 74% relapse rate in the induced remission group, but only an 8% relapse rate in the spontaneous remission group (p