Cacoub P, Sbaï A, Wechsler B, Amoura Z, Godeau P, Piette J C
Service de médecine interne, CHU Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris.
Arch Mal Coeur Vaiss. 2000 Dec;93(12):1511-4.
Acute idiopathic pericarditis is complicated by recurrence in 15 to 30% of cases. The preventive treatment of recurrences is not well codified. Aspirin, non-steroidal anti-inflammatory drugs and corticoids are the commonest prescribed treatments. The objective of this study was to assess the value of colchicine in the prevention of recurrences of acute idiopathic pericarditis. Twenty-eight cases of recurrent acute pericarditis (2 episodes, 1 month between each episode) admitted to a department of internal medicine between 1989 and 1999 were reviewed. Analysis was concentrated on the 13 idiopathic forms. The subjects were 7 women and 6 men with an average age of 41 years (10-62) at the time of the first episode of acute pericarditis. These 13 patients were treated with colchicine (1 to 2 mg/day) after failure of conventional treatment (aspirin 13/13, NSAID 13/13, steroids 9/13 and pericardiocentesis 3/13). Ten patients were followed up regularly (6 months after starting colchicine) and were improved with respect to number, duration and intensity of their recurrences. The average duration of colchicine therapy was 17 +/- 14 months (6-48). Progressive withdrawal of NSAID and steroids was obtained in 8/10 cases. The authors conclude that colchicine is useful in the prevention of recurrence of acute pericarditis. It may be proposed as treatment of choice, especially in the idiopathic forms.
15%至30%的急性特发性心包炎病例会出现复发并发症。复发的预防性治疗尚无明确规范。阿司匹林、非甾体抗炎药和皮质类固醇是最常用的处方治疗药物。本研究的目的是评估秋水仙碱在预防急性特发性心包炎复发中的价值。回顾了1989年至1999年间内科收治的28例复发性急性心包炎病例（发作2次，每次发作间隔1个月）。分析集中在13例特发性病例上。研究对象为7名女性和6名男性，首次急性心包炎发作时的平均年龄为41岁（10至62岁）。这13例患者在常规治疗（阿司匹林13/13、非甾体抗炎药13/13、类固醇9/13和心包穿刺术3/13）失败后接受了秋水仙碱治疗（1至2毫克/天）。10例患者得到定期随访（开始使用秋水仙碱后6个月），复发的次数、持续时间和强度均有所改善。秋水仙碱治疗的平均持续时间为17±14个月（6至48个月）。8/10的病例成功逐渐停用了非甾体抗炎药和类固醇。作者得出结论，秋水仙碱对预防急性心包炎复发有用。它可被推荐为首选治疗药物，尤其是在特发性病例中。
