Maisch B, Karatolios K
Klinik für Innere Medizin, Schwerpunkt Kardiologie, Universitätsklinikum Giessen und Marburg, Baldingerstrasse 1, 35033, Marburg, Deutschland.
Internist (Berl). 2008 Jan;49(1):17-26. doi: 10.1007/s00108-007-1961-3.
Pericarditis is an inflammatory disorder of the pericardium with or without an associated pericardial effusion. The diagnosis is based on the clinical manifestations and typical ECG changes. Echocardiography is essential to reveal the size of the pericardial effusion and to determine its hemodynamic significance. The precise etiology of pericarditis may be established by pericardiocentesis, pericardioscopy and targeted biopsy and consecutive pericardial fluid and biopsy analysis by molecular biology, cytology, microbiology and immunological techniques. Non steroidal anti-inflammatory drugs and/or colchicine are the mainstay of anti-inflammatory treatment of pericarditis. Systemic corticoid treatment should be restricted to patients with associated autoimmune disorder, relapsing pericarditis and as a complementary therapy in tuberculous pericarditis. In autoreactive pericarditis intrapericardial instillation of triamcinolone is effective with few side effects. In malignant pericarditis the intrapericardial administration of cisplatin prevents early recurrences.
心包炎是心包的一种炎症性疾病,可伴有或不伴有相关的心包积液。诊断基于临床表现和典型的心电图变化。超声心动图对于揭示心包积液的大小以及确定其血流动力学意义至关重要。心包炎的确切病因可通过心包穿刺、心包镜检查和靶向活检,并通过分子生物学、细胞学、微生物学和免疫学技术对心包积液和活检进行连续分析来确定。非甾体类抗炎药和/或秋水仙碱是心包炎抗炎治疗的主要药物。全身皮质类固醇治疗应仅限于伴有自身免疫性疾病、复发性心包炎的患者,以及作为结核性心包炎的辅助治疗。在自身反应性心包炎中,心包内注射曲安奈德有效且副作用少。在恶性心包炎中,心包内给予顺铂可预防早期复发。