抽象的

背景：皮质类固醇抑制肺结结病中的疾病活动，它们的使用产生症状，射线照相和功能改进。然而，有关于它们对条件的整体自然历史的影响和长期益处的影响是未经证实的。方法：在多期面研究中招募了患有肺射线照相阴影的患者。那些在进入研究后的前六个月的人，六个月内既不分配症状的症状泼尼松龙都不会出现放射学改善，以获得长期类固醇治疗（L）或选择性治疗（群体），定期评估在随后的五年。L中的患者计划在达到和维持最大射线照相清除的政策中，患者至少接受18个月的类固醇治疗，而在群体治疗中，仅在症状或恶化的肺功能的发展中保留使用。在研究期间定期评估症状，放射线摄影和呼吸功能。结果：随访一百四十九名患者：33名必修泼尼松龙在六个月内进行麻烦症状，58次在此期间显示射线照相改善。将剩余的58名患者分配给L（n = 27）和s（n = 31）。虽然差异不大，但L患者患者症状，呼吸功能和射线照相外观症状，呼吸功能和射线照相外观更大。 After adjusting for differences at the time of allocation, the average difference in vital capacity between groups L and S at final assessment was 9% of the predicted value. Side effects of treatment were frequent but usually mild, necessitating withdrawal in only two individuals. CONCLUSIONS: After excluding those individuals who required steroids for control of symptoms, approximately half of the remaining patients with sarcoidosis and pulmonary shadowing showed spontaneous radiographic improvement during six months of observation. In those in whom the radiograph failed to improve, prolonged steroid treatment with the aim of optimising radiographic appearances resulted in a significantly better long term functional outcome.