Povezanost bronhoskopske, kliničke i radiološke dijagnostike kod obolelih od sarkoidoze
The correlation of bronchoscopic, clinical and radiologic diagnostics in patients with sarcoidosis
Докторанд
Popević, Spasoje B.Ментор
Jovanović, Dragana M.Чланови комисије
Mihailović-Vučinić, VioletaŠkodrić-Trifunović, Vesna
Mandarić, Dragan
Метаподаци
Приказ свих података о дисертацијиСажетак
Uvod: Sarkoidoza je multisistemska bolest nepoznate etiologije koja se karakteriše
prisustvom nekazeifikujućih granuloma u tkivima i organima. Složena
patogenetska osnova sarkoidoze uslovljava nepostojanje jedinstvenog
dijagnostičkog testa za sarkoidozu. Neophodno je utrditi koja dijagnostička metoda
i na koji način najbolje odražava tok bolesti, i koji bi od kliničkih parametara
najbolje to mogli da predvide.
Materijal i metode: Opservacijsko (deskriptivno) kliničko istraživanje (studija
preseka) obavljeno je u Klinici za pulmologiju Kliničkog centra Srbije.
Prospektivnom analizom je obuhvaćen uzorak od 571 bolesnika sa bronhoskopski
i histološki verifikovanom sarkoidozom. Svim bolesnicima je uzeta detaljna
anamneza sa procenom kliničkih simptoma, urađena radiografija grudnog koša i
laboratorijske analize, kao i bronhoskopija sa biopsijom. Dobijeni rezultati su
kodirani, uneti u bazu podataka i analizirana je statistička povezanost pojedinih
varijabli laboratorijskih, kliničkih, radio...grafskih i endoskopskih karakteristika
sarkoidoze.
Cilj ispitivanja bio je utvrditi povezanost kliničkih, radiografskih i
bronhoskopskih nalaza kod obolelih od sarkoidoze, u cilju procene kliničkog toka i
aktivnosti bolesti.
Rezultati: Bilo je više žena (66,1%) nego muškaraca (33,9%). Odnos polova
iznosio je 1,94 u korist žena. Kod većine bolesnika sa plućnom sarkoidozom
dominantni simptomi i znaci su bili: suv i uporan kašalj (501-88,2%), promene na
koži (564-98,8%) Najveći broj bolesnika je bio u prvom stadijumu bolesti, a
najmanje ih je bilo u trećem i četvrtom stadijumu. Kod muškaraca je registrovana
statistički značajno veća aktivnost angiotenzin konvertujućeg enzima (ACE) i
hitotriozidaze. Visoko je statistički značajna razlika u aktivnosti hitotriozidaze u
serumu između bolesnika sa aktivnom i neaktivnom sarkoidozom...
Introduction. Sarcoidosis is a multisystemic disease of unknown aetiology which
is characterized by presence of non-caseating granulomas in various tissues and
organs. Complex pathogenetic basis of the sarcoidosis is causing non existence of
unique diagnostic test for sarcoidosis. It is necessary to determine which
diagnostic test and in what way reflects the course of the disease and which of the
clinical parametars are the best in its prediction.
Matherial and methods. Observational (descriptive) clinical study (crosssectional
study) was performed in Clinic for Pulmonary Diseases of Clinical Center
of Serbia. The prospective analysis included 571 patient with bronchoscopically
and histopathologically verified sarcoidosis. In all patients, detailed anamnesis was
taken, with assessment of clinical symptoms, then chest radiography and
laboratory analyses, as well as bronchoscopy with biopsy. Results were coded,
entered into database and statistical significance of correlation between va...riableslaboratory,
clinical, radiographic and endoscopic findings-was analyzed with
appropriate statistical tests.
Results. There were more women (66.1%) then men (33.9%). Gender ratio was
1.94 in favor of women. In most patients with pulmonary sarcoidosis dominat
symptoms and signs were: dry, persistent cough (in 501 patient-88.2%) and skin
changes (in 564 patients-98.8%). Most of the patients were in the first stage of the
disease and much less in the third and fourth stage. Statistically significantly higher
activity of both angiotensine-converting enzyme (ACE) and chitotriosidase in
serum was noticed in men. Highly statistically significant is the difference in serum
chitotriosidase activity between patients with active and inactive sarcoidosis.
Serum ACE activity is also statistically significantly different between patients with
active and inactive disease. The highest chitotriosidase activity is verified in
patients in the second radiographic stage of sarcoidosis...