Garg Rajeev, Singh Avneet, Chockalingam Anand
Department of Internal Medicine, Division of Cardiology, University of Missouri-Columbia, Columbia, MO, USA.
Congest Heart Fail. 2009 Jul-Aug;15(4):199-201. doi: 10.1111/j.1751-7133.2008.00032.x.
Effusive constrictive pericarditis (ECP) is a relatively infrequent pericardial condition. The diagnosis is typically made when symptoms and right heart pressure elevation persist despite drainage of pericardial effusion. Visceral and parietal pericardial stripping is an extensive procedure with significant morbidity and mortality but is widely considered the only effective treatment. Recent studies suggest that up to 10% of constriction may be reversible, and a newer series has reported spontaneous complete resolution of symptoms in a subset of ECP patients. In this review, the authors describe 2 patients with ECP who were managed successfully with steroids and colchicine, respectively, thus obviating the need for surgery. The authors also review the current understanding of this reversible pericardial pathology and explore the possible role for colchicine in treating this condition.
渗出性缩窄性心包炎（ECP）是一种相对罕见的心包疾病。通常在心包积液引流后症状和右心压力升高仍持续存在时作出诊断。脏层和壁层心包剥脱术是一种广泛开展的手术，具有较高的发病率和死亡率，但被广泛认为是唯一有效的治疗方法。最近的研究表明，高达10%的缩窄可能是可逆的，并且一个更新的系列报道了一部分ECP患者症状自发完全缓解。在这篇综述中，作者描述了2例分别成功使用类固醇和秋水仙碱治疗的ECP患者，从而避免了手术的需要。作者还回顾了目前对这种可逆性心包病理的认识，并探讨了秋水仙碱在治疗这种疾病中的可能作用。
