RESUMO
Comparison of the state of 83 patients with histologically confirmed sarcoidosis observed with a 10 year interval revealed remission in 47% of the cases. The main factors having negative effect on prognosis of the disease included extrapulmonary symptoms, the use ofcorticosteroids (at all stages, especially at stage I and in Lofgren syndrome) and antituberculosis drugs, positive TB test. Risk factors of relapses were stage II sarcoidosis, the use of systemic corticosteroids in patients with Lofgren syndrome and antituberculosis drugs, initially low FEV1/FVLC ratio and the number of lymphocytes in peripheral blood.
Assuntos
Antituberculosos/uso terapêutico , Glucocorticoides/uso terapêutico , Sarcoidose , Adulto , Intervalo Livre de Doença , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Gravidade do Paciente , Prognóstico , Radiografia , Recidiva , Testes de Função Respiratória/métodos , Fatores de Risco , Federação Russa/epidemiologia , Sarcoidose/diagnóstico , Sarcoidose/epidemiologia , Sarcoidose/fisiopatologia , Sarcoidose/terapiaRESUMO
Three hundred and thirty-five patients with bronchial asthma (BA) and 534 patients with chronic obstructive lung disease (COLD) were examined. Before and after tests using salbutamol, phenoterol, ipratropium bromide and a fixed combination of phenoterol and ipratropium bromide, the forced expiratory flow-volume curve was recorded in the patients on each visit (1008 and 1398 visits of patients with BA and COLD, respectively). The study was controlled open-labeled, and prospective. All the bronchodilators were found to be effective in both BA and COLD. However, in asthmatic patients without (less than 4%) and with (more than 5%) eosinophilia, the increase in forced expiratory volume per second (FEV1) was 23.7+/-22.1% and 16.0+/-14.6% of the baseline values, respectively (p < 0.05). Among these patients with ESR of less than 100 mm/hour, the increase in FEV1 was significantly higher--21.7+/-19.7% than in those who had ERS more than 15 mm/hour and this was 13.8+/-17.9% of the baseline values (p < 0.05). Among asthmatic patients, more than 15% increases in FEV1 after administration of bronchodilators were noted in 48% of the patients untreated with inhaled corticosteroids (ICS) and in 61% of the ICS-treated patients (chi2 = 6.55; d.f. = 1; p = 0.01). Among ICS-treated and untreated patients with BA, the mean increase in FEV1 was 24.4+/-22.5% and 19.6+/-22.0% of the baseline values, respectively (p < 0.05). In COLD patients, these differences were absent. It has been concluded that eosinophilic inflammation typical of BA decreases the effect of bronchodilators in BA and that inhaled steroids improve it.
