Zhang Li-Hua, Ni Chao, Guo Li-Lin
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2008 Sep;36(9):812-5.
To summarize the clinical and pathological characteristics of constrictive pericarditis in China.
Data from 150 patients with constrictive pericarditis who admitted to our hospital from 2000 to 2007 were retrospectively analyzed.
Constriction pericarditis was detected by echocardiography in 149 out of 150 patients. Pericardial effusion was evidenced in 59.3% patients (89/150). The diagnostic accuracy rate for identifying constrictive pericarditis by echocardiography (98.7%, 107/109) was comparable to that of surgical diagnosis (100%, 109/109). Tuberculosis was the main cause of constrictive pericarditis in this cohort (78.7%, 118/150) including 25 (16.7%) cases with pathological or etiological evidences of tubercular pericarditis, 8 (5.3%) cases with pathologically active tuberculous focus elsewhere in the body, 66 (44.0%) cases with typical clinical tuberculosis manifestation and responded to anti-tubercular therapy and 19 (12.7%) cases with a diagnosis of suspicious tuberculosis. Pericardiectomy was performed in 108 cases and pericardial biopsy and surgical drainage was performed in 1 patient. In hospital death rate was 8.7% (13/150, 4 tubercular patients and 9 non-tubercular).
Tuberculosis is the leading cause of constrictive pericarditis in this cohort and the best diagnosis tool is echocardiography other than pathological and etiological findings in pericardium.
总结我国缩窄性心包炎的临床及病理特征。
回顾性分析2000年至2007年我院收治的150例缩窄性心包炎患者的资料。
150例患者中149例经超声心动图检测出缩窄性心包炎。59.3%的患者（89/150）有胸腔积液。超声心动图诊断缩窄性心包炎的准确率（98.7%，107/109）与手术诊断准确率（100%，109/109）相当。结核是该队列中缩窄性心包炎的主要病因（78.7%，118/150），其中25例（16.7%）有结核性心包炎的病理或病因学证据，8例（5.3%）身体其他部位有病理活动性结核病灶，66例（44.0%）有典型临床结核表现且抗结核治疗有效，19例（12.7%）诊断为可疑结核。108例行心包切除术，1例行心包活检及手术引流。住院死亡率为8.7%（13/150，4例结核患者和9例非结核患者）。
结核是该队列中缩窄性心包炎的主要病因，最佳诊断工具是超声心动图，而非心包的病理及病因学检查结果。
