RT杂志文章SR电子T1儿童肺结节病:随访研究JF欧洲呼吸杂志JO Eur Respir J FD欧洲呼吸学会SP 628 OP 635 DO 10.1183/09031936.01.17406280 VO 17 IS 4 A1188bet官网地址巴库拉尔A1 N.勃朗A1 M. Boulé A1 B.福鲁A1 K。查德拉特A1 L.博康-吉博德A1 G.图尼尔A1 A。克莱门特YR 2001 UL //www.qdcxjkg.com/content/17/4/628.abstract AB肺结节病在儿童中的进展仍然很少记录。这项工作的目的是收集关于结节病儿童肺部预后的随访信息，并获得与糖皮质激素治疗的最佳长度和方案讨论相关的数据。在本研究中，作者在21名儿童肺结节病转诊超过10年的时间，报告了至少4年的随访记录。随访期间对疾病的评估包括分析临床表现、胸片、肺活量测定的肺功能检查(VC)、动态肺顺应性(CL,dyn)、CO肺转移(TL,CO)和动脉血气，以及测定总细胞数和差异细胞数的支气管肺泡灌洗(BAL)。在初步评估后，对四个未接受治疗的儿童进行了仔细观察。17名儿童开始接受皮质类固醇治疗。结果分析显示，治疗6-12个月后，本病大部分临床表现及胸片异常消失，对VC、TL、CO均有明显的有益作用。类固醇治疗18个月后，肺功能测试无明显改善，主要表现为CL、dyn持续改变。BAL研究的结果记录了在整个随访过程中淋巴细胞数量增加的肺泡炎的存在。 Relapses were observed in four children during tapering of prednisone; they were not reported after discontinuation of steroid therapy.Taken together data obtained in the presented population can lead to the following suggestions for the management of pulmonary sarcoidosis in children. BAL should be performed at the initial evaluation to document alveolitis; however, nothing seems to be gained from repeating this investigation during follow-up in the absence of specific reasons. Once the decision to initiate glucocorticoid therapy is made, 18 months may be a reasonable treatment duration. Discontinuation of therapy can be decided even if the pulmonary function tests remain abnormal, but the child should then be carefully monitored for a relapse.