ОГАУЗ «Томская областная клиническая больница», г. Томск, РФ 2 ФГБОУ ВО «Сибирский государственный медицинский университет» МЗ РФ, г. Томск, РФ Цель исследования: изучить рентгенологические и морфологические параллели при саркоидозе органов дыхания (СОД).Материалы и методы. В исследование включен 121 пациент с СОД в возрасте от 21 года до 66 лет, находившийся на обследовании в 2007-2019 гг. Анализ рентгенологических проявлений саркоидоза оценивался по основным параметрам (симметричность поражения, размер внутригрудных лимфоузлов, наличие диссеминации, пневмофиброз). Проводилось расширенное морфологическое исследование биоптатов с изучением количественного и качественного состава гранулем.Результаты. Использование компьютерной томографии органов грудной клетки показало несоответствие лучевой картины при СОД традиционной классификации стадий по Wurm. Изменения в паренхиме легких и увеличение лимфоузлов средостения обнаружены у всех больных с I-III стадиями. Составляющие клеточных элементов воспалительного инфильтрата при разных стадиях СОД не отличались. Однако с утяжелением лучевой стадии нарастало количество гранулем и имелась прямая корреляционная зависимость между количеством гранулем в биоптате и рентгенологической стадией по Wurm (r = 0,24; p < 0,05), а также увеличивалась частота гранулем с некрозом (r = 0,39; p < 0,05).
As a rule, heart damage in patients with sarcoidosis of respiratory organs (SOD) is not diagnosed in time, so a very important and urgent task is to identify common heart rhythm and conduction disorders.The aim of the study was to investigate the main clinical manifestations of sarcoidosis in SOD, depending on the peculiarities of the disease course and to compare the frequency and severity of pulmonary and extrapulmonary manifestations of sarcoidosis, including myocardial lesions and electrocardiographic (ECG) signs of heart rhythm disorders.Methods. In the period 2006– 2016, the pilot open prospective uncontrolled study conducted at the Pulmonology Department of the Regional State Autonomous Healthcare Institution "Tomsk Regional Clinical Hospital" included patients (n = 84) aged 20–67 years with the diagnosis of SOD. Patients were divided into 2 clinical groups: the 1st comprised 45 (53.5%) patients with a favorable course of sarcoidosis, the second one included 39 (46.4%) patients with an unfavorable course of the disease. A full range of studies was carried out, including the analysis of medical history and clinical and epidemiological data, instrumental methods (including ECG and Holter ECG monitoring (HM), pathomorphological study of lung biopsy samples.Results. According to the data of frequency analysis of occurrence of pulmonary and extrapulmonary clinical manifestations in ODS, it was shown that the leading clinical manifestations, most frequently occurring in patients of both groups, included asthenia syndrome (72.6%), bronchial syndrome (66.7%) and fever syndrome (33%). In 33% of cases, clinical manifestations of myocardial damage were detected. In 41 (51.2%) patients in both groups, changes on ECG were recorded at rest. Regardless of the course of the disease, in 23.5% of patients of both clinical groups, according to the results of the HM ECG, rhythm and conduction disturbances were found – a combination of ventricular arrhythmias and conduction disorders (ventricular extrasystole and right His bundle branch block of various degrees) and a combination of supraventricular arrhythmias and conduction disturbances (supraventricular extrasystole and right His bundle branch block of various degrees).Conclusion. Thus, regardless of the severity of the disease course, SOD patients are concerned about complaints from both respiratory system and extrapulmonary manifestations, including cardiac complaints, as well as heart rhythm and conduction disorders (according to the results of ECG and HM ECG), the frequency of which, according to the comparative analysis, has not significantly changed in both clinical groups, which indicates the non-specific character of clinical manifestations.
Aim. The aim of the study was to study the frequency of occurrence of exposure to harmful occupational factors in patients with sarcoidosis of the respiratory organs, depending on the course of the disease. Materials and methods. An open prospective study included 121 patients with sarcoidosis of the respiratory system from the age of 21 to 66 years, from 20072019. The diagnosis was histologically confirmed in all patients. Patients underwent a set of laboratory and instrumental examinations, studied profane history. The presence of a history of contact with harmful and dangerous production factors was clarified. To determine the effect of a harmful production factor on the course of sarcoidosis, patients were divided into 2 clinical groups: the first group consisted of 85 (70.2%) patients with a favorable course of the disease, the second group included 36 (29.8%) patients with an unfavorable course sarcoidosis (standardization coefficient between groups 2.4:1). Results and discussion. Among the examined patients of working age prevailed (87%). Patient groups were comparable by age, but statistically differed by gender (chi2=9.75, p=0.0018). Frequency analysis of the occurrence of harmful occupational factors in sarcoidosis of the respiratory organs showed that the most frequently encountered factors in all the studied groups were contact with chemical hazards. Conclusion. The presence of contact with harmful production factors increases the risk of an unfavorable course of sarcoidosis by more than 2 times.
2ОГАУЗ «Томская областная клиническая больница», г. Томск, Р осси я Саркоидоз представляет собой системное заболевание, характеризующееся развитием хронического иммунного воспаления и образованием гранулем. С целью изучения патоморфологических особенностей гранулемы важно знать клинико-морфологические и иммунологические варианты течения процесса. В последнее время отмечена отрицательная тенденция в динамике патоморфоза саркоидоза. В этой связи важным является изучение во просов прогнозирования развития данного заболевания, в том числе и особенностей течения гранулематозного воспалительного процесса при различных клинических вариантах с точки зрения не только диагностики, но и определения дальнейшей тактики ведения пациентов с этой патологией.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.