Siles Rubio J R, Anguita Sánchez M P, Ruiz de Castroviejo del Campo J, Castillo Domínguez J C
Unidad de Cardiología, Hospital Infanta Margarita, Cabra, Córdoba.
Rev Clin Esp. 2006 Mar;206(3):141-3. doi: 10.1016/s0014-2565(06)72744-8.
The aim or our study was to evaluate the main clinical and etiological features or primary acute pericarditis with severe pericardial effusion without cardiac tamponade. Our experience included 35 patients with this problem diagnosed in the last 5 years. Patients with a previous potential etiology for acute pericarditis were excluded. The diagnostic protocol identified a specific etiology in 20% of patients, the most frequent being idiopathic forms. Patients with severe pericardial effusion without cardiac tamponade who had a favourable clinical outcome on nonsteroidal antiinflammatory drugs therapy presented a lower proportion of specific etiology than those with a poor response to this therapy (8% versus 45%; p = 0.03). An exhaustive etiological investigation, including diagnostic pericardiocentesis should be reserved for these patients with unfavourable response to antiinflammatory drug therapy.
我们研究的目的是评估伴有严重心包积液但无心脏压塞的原发性急性心包炎的主要临床和病因学特征。我们的经验包括过去5年中诊断出的35例有此问题的患者。排除既往有急性心包炎潜在病因的患者。诊断方案在20%的患者中确定了特定病因，最常见的是特发性类型。在非甾体类抗炎药治疗中临床结局良好的伴有严重心包积液但无心脏压塞的患者，其特定病因的比例低于对该治疗反应不佳的患者（8%对45%；p = 0.03）。对于这些对抗炎药物治疗反应不佳的患者，应进行包括诊断性心包穿刺术在内的详尽病因学调查。
