| Objective:Summarize the general diagnosis and treatment data of sarcoidosis patients to increase the understanding of clinicians on sarcoidosis;To analyze the positive rate of sarcoidosis diagnosis by various sampling methods,and to guide clinicians to choose the diagnostic methods of sarcoidosis.Method:Retrospective analysis was performed on the clinical diagnosis and treatment data of 58 patients with sarcoidosis who were first diagnosed and hospitalized in our hospital from January 2014 to October 2019.The patient's age,gender,clinical symptoms,concomitant symptoms,smoking history,chest imaging,serology,lung function,abdominal ultrasound,cardiac ultrasound,extra-thoracic lymph node ultrasound and sampling methods were summarized.Later,SPSS 22.0 system was used for data processing.If P <0.05,the difference was statistically significant.Results:A total of 58 patients with sarcoidosis were included in this study,including 40 females and 18 males.The age of onset was 28-61 years old,and the highest incidence was 72.41% at 41-60 years old.The average age of onset was 42±9.91 for male patients and 49.22±6.89 for female patients.The age of onset of female patients was larger than that of male patients,and the difference was statistically significant(P=0.012<0.05).The proportion of non-smokers in patients with sarcoidosis was higher at 6.25 times that of smokers.91.38% of the patients were mainly treated in the department of respiratory medicine or thoracic surgery of our hospital for respiratory symptoms,presenting as dry cough,cough,sputum cough,dyspnea,accompanied by fever,fatigue,weight loss and other non-specific symptoms,often involving the skin,external thoracic lymph nodes,eyes,nasal cavity,spleen and other parts.The clinical symptoms of sarcoidosis lack specificity,and it often requires repeated visits to the doctor for a clear diagnosis.In this study,the shortest course of disease was 4 days,the longest was 5 years,and the median course of disease was 2 months.In this study,it was found that the blood routine had a great influence on the lymphocyte count,and the lymphocyte count was reduced in 25 cases(43.10%).Among 51 cases,2 cases(3.92%)were elevated.In some cases,c reactive protein,elevated blood concentration,and anti-rheumatic immune index were abnormal.according to the imaging staging in patients with sarcoidosis ? period,most(78.95%),main show is on imaging of mediastinal lymph nodes and lungs door,pure of mediastinal lymph node enlargement,mediastinal lymph in unilateral lung door lymph node enlargement and pure hilumlymph node enlargement are relatively rare,nodules,patch shadow also relatively common.Nineteen patients completed lung function tests,and 73.68% of them presented abnormalities.Pathological tissue is the gold standard for the diagnosis of sarcoidosis.In this study,the diagnosis was confirmed by fiberoptic bronchoscopy,external thoracic lymph node biopsy,mediastinoscopy,ct-guided puncture biopsy of mediastinal lymph node,thoracoscopy,skin biopsy and nasal mass biopsy.Among them,41 patients underwent fiberoptic bronchoscopy,with a positive rate of 90.24%,and 4 patients who underwent TBNA alone had no definite diagnosis.The positive rate of diagnosis of sarcoidosis was compared with that of EBB,TBLB and TBNA alone or in combination under fiberoptic bronchoscopy.The results suggested that EBB should be performed first for the mucosal nodular changes under fiberoptic bronchoscopy.The positive rate was higher and the difference was statistically significant(P=0.029<0.05).TBNA combined with TBLB or EBB is recommended for patients with mediastinal lymph node enlargement to improve the positive rate of diagnosis,and the difference is statistically significant(P=0.019<0.05).The positive rate of other methods was as high as 100%,and there was no statistical difference compared with the method of fiberoptic bronchoscopy(P>0.05).Conclusion:1?The prevalence of sarcoidosis in women is 2.2 times that in men,and the age of onset in women is older than that in men.2?Sarcoidosis is more likely to occur in non-smokers and is 6.25 times more likely to occur in non-smokers.3 ? 91.38% of tubercle patients with respiratory symptoms in our hospital treatment,and mostly ? period.The main manifestations are dry cough,cough,expectoration and dyspnea.On imaging,the main manifestations were hilar and mediastinal lymph node enlargement,and nodules and plaques were also common.4?The course of sarcoidosis varies from several days to several years,with a median course of 2 months.5?The positive rate of fiberoptic bronchoscopy was 90.24%,and the positive rate of other methods was as high as 100%.EBB should be performed first as the change of mucous membrane nodules was observed under fiberoptic bronchoscopy.TBNA combined with TBLB or EBB is recommended for patients with mediastinal lymph node enlargement to improve the positive rate of diagnosis. |
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