CAJ | 학술논문

结节病是一种以非干酪性肉芽肿为病理特征的系统性疾病.其病因和发病机制尚不明确,但是近年来取得了不少新的认识,尤其是在遗传因素和免疫学因素方面.如人白细胞抗原HLADRB1基因的多形性与发病的关系,炎性趋化因子CCL15等多种细胞因于在发病过程中所起的作用等.多种高新技术应用于诊断过程以获得病理学结果,支气管肺泡灌洗液中淋巴细胞计数和CD4/CD8比值测定对诊断和鉴别诊断的意义更加明确.治疗方面皮质类同醇及免疫抑制剂仍然是首选,但基于激素的不良反应及对病因和发病机制的新认识,一些新疗法,如抗肿瘤坏死因子α治疗等,已逐渐成为治疗快速进展和(或)难治性的结节病的一个新选择,并取得了可喜的结果.现将以上进展作一综述.
결절병시일충이비간락성육아종위병리특정적계통성질병.기병인화발병궤제상불명학,단시근년래취득료불소신적인식,우기시재유전인소화면역학인소방면.여인백세포항원HLADRB1기인적다형성여발병적관계,염성추화인자CCL15등다충세포인우재발병과정중소기적작용등.다충고신기술응용우진단과정이획득병이학결과,지기관폐포관세액중림파세포계수화CD4/CD8비치측정대진단화감별진단적의의경가명학.치료방면피질류동순급면역억제제잉연시수선,단기우격소적불량반응급대병인화발병궤제적신인식,일사신요법,여항종류배사인자α치료등,이축점성위치료쾌속진전화(혹)난치성적결절병적일개신선택,병취득료가희적결과.현장이상진전작일종술.
Sarcoidosis is a multisystem inflammatory disease of unknown etiology and pathogenesis, pathologically characterized by noncaseating granulomas. But many new recognitions are acquired in recent years, especially on genetic and immunological factors. For example, the relationship between human leukocyte antigen HLA DRB1 gene polymorphism and pathogenesis, the effects of chemokines such as CCL15 on the development of this disease. Many new techniques are used for the diagnosis process to obtain pathologic result. The significance of lymphocyte count and CD4/CD8 ratio in bronchoalveolar lavage fluid is more definite in diagnosis and differential diagnosis, The corticosteroids and immunosuppressive agents are still the first choice to treat the disease. But based on the adverse effect of corticosteroids and the new knowledge about etiology and pathogenesis, some new therapies, such as anti-tumor necrosis factor-α, have become new choices on treating rapid progressing and/or refractory sarcoidosis and achieved encouraging results. This article summaries the above progress.