Godeau P, Derrida J P, Bletry O, Herreman G
Sem Hop. 1975 Oct 9;51(40):2393-2400.
The authors report ten cases of acute recurrent pericarditis observed over a period of 5 years and emphasize the frequency of these relapses involving 15 to 20% of cases of acute pericarditis. Usually, no cause is found and, althrough an immunological mechanism has been suggested, there is no common test which may confirm or disprove this theory. The risk of ultimate constrictive pericarditis is minimal and this risk is thus not taken into consideration in deciding on treatment. On the other hand, the undesirable effects of corticosteroids which favour relapses, seem to be demonstrated. The use of corticosteroids in cases of acute pericarditis should thus be exceptional and one should prefer non-steroid anti-inflammatory drugs. Immunosuppressors and pericardectomy should be reserved for the rare forms where the disease progresses and relapses continue after cortisone has been stopped.
作者报告了在5年期间观察到的10例急性复发性心包炎病例，并强调这些复发的频率涉及急性心包炎病例的15%至20%。通常，找不到病因，尽管有人提出了免疫机制，但没有一项常规检查能够证实或反驳这一理论。最终发生缩窄性心包炎的风险极小，因此在决定治疗方案时不考虑这一风险。另一方面，似乎已证实皮质类固醇会产生有利于复发的不良影响。因此，急性心包炎病例中皮质类固醇的使用应属例外，而应首选非甾体抗炎药。免疫抑制剂和心包切除术应仅用于罕见的病例，即疾病在停用可的松后仍进展并持续复发的情况。
