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SARCOIDOSIS和肺

Sarcoidosis can occur in any organ of the body. In about 90% of patients, sarcoidosis affects the lungs and / or lymph glands. This is also known as ‘pulmonary sarcoidosis’. The information on this page is for anyone affected by pulmonary sarcoidosis.

此頁面上的信息是在結節病專家的幫助下編制的 Prof S. Birring, Consultant Respiratory Physician at Kings College Hospital, London and Prof L.P. Ho, Respiratory Physician at Oxford University NHS Foundation Trust.

肺和結節病的功能

The lungs transfer oxygen from the air we breathe into the blood. At the same time, carbon dioxide leaves the blood through the lungs. This exchange happens in the lungs.

In pulmonary sarcoidosis, abnormal immune cells (known as ‘granuloma’) gather in the lungs and disrupt the uptake of oxygen.

These granuloma can also result in scarring. Scarring prevents the lungs stretching fully, and therefore limits their capacity. This in turn leads to loss of fully functional lung tissue and, eventually, shortness of breath.

In addition, these granuloma may develop around the lymphatic (or ‘lymph’) system of the lungs. The lymph system is an important part of the immune system that circulates the immune cells in the body.

 

Symptoms of Lung Sarcoidosis

有時,肺結節病的症狀突然開始,並且不會持續很長時間。在其他患者中,症狀可能逐漸發展並持續多年。

有些人根本沒有任何症狀,並且在進行常規胸部X光檢查或其他檢查後被告知患有結節病。

肺結節病的常見症狀包括:

  • fatigue and feeling ‘washed out’
  • 呼吸急促,特別是運動時
  • dry and persistent cough
  • 胸痛

您可能會讀到顧問將結節病分類為“結節病的階段”。實際上,這是英國臨床醫生很少使用的技術。

與肺結節病一起生活

結節病對人的影響非常不同 - 每個病例都是獨一無二的。然而,對於患有結節病的人來說,有一些共同的經歷。

患結節病的患者常常感到疲倦和昏昏欲睡(疲勞),減輕體重或患上發燒和盜汗。

Sometimes symptoms may suddenly get worse – this is known as a ‘flare-up’. This may be triggered by stress, infections, a change in environment or, often, nothing recognisable.  

It is important to make sure you eat healthily, pace yourself and talk to friends and family about your sarcoidosis. You should discuss your condition early on with your employer – use the SarcoidosisUK Leaflet 雇主的信息.

結節病可使患者感到害怕和孤立 - 儘早識別心理健康問題並尋求支持。請 聯繫SarcoidosisUK 或您的全科醫生獲得專業支持。

了解您的情況的技巧

Sarcoidosis can be difficult to diagnose, particularly if the symptoms aren’t obvious. Multiple tests or scans may be needed to make a diagnosis.

X射線 can give a picture of lung abnormalities. Generally, if abnormalities are found, additional tests are performed to confirm any diagnosis.

Lung Function Tests. Spirometry tests how well you breathe in and out. Lung volume tests measure the total size of your lungs. Gas transfer tests measure the amount of oxygen that passes from your lungs into your blood.

CT掃描 (also called CAT scan or computed tomography) combines X-rays and computer technology to create detailed images of the inside of your body.

MRI掃描 use magnetic fields and radio waves. They show some abnormal tissue clearer than CT scans. MRI is rarely used with the lungs but may be useful to check if other organs like the bones and heart are affected.

支氣管鏡檢查. Your doctor may use a thin flexible camera inserted through your mouth to examine your lungs for signs of sarcoidosis. They may then remove tiny amounts of lung or lymph nodes to help make a diagnosis (a biopsy).

In rare cases, surgery is required to obtain a biopsy. This technique is often used when doctors want to be sure to confirm the disease as sarcoidosis. The most common technique for this is called VATS (video-assisted thoracoscopic surgery).

展望

Sarcoidosis affects people differently and often follows an unpredictable course. Most patients with pulmonary sarcoidosis recover within a few years; sometimes no treatment is needed.

Some patients are more severely affected with symptoms worsening over time – more prolonged treatment may be necessary. This is known as chronic sarcoidosis.  

Treating Pulmonary Sarcoidosis

There is no cure for sarcoidosis. When treatment is required, its purpose is to prevent lung inflammation and scarring, worsening of the disease and to improve quality of life. Treatment can help relieve the symptoms as the disease runs its course.

Many patients experience side-effects from medication. You will discuss with your doctor the best treatment regime for you; regular check-ups may be necessary.

皮質類固醇 (commonly called 潑尼松龍) may be used for a year or more. These drugs act to suppress the disease. A high dose is usually prescribed at the start of the treatment, before being reduced to a ‘maintenance dose’.

NSAIDS (Non-steroidal Anti-Inflammatory Drugs) are anti-inflammatory drugs similar to aspirin; they are also mild painkillers. They are often used to reduce pain (e.g. joint pain).

Methotrexate and Azathioprine can be given in combination with corticosteroids for those with more severe sarcoidosis.

Page last updated: August 2019. Next review: August 2021.

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