Kaplan K, Davison R, Parker M, Przybylek J, Light A, Bresnahan D, Ribner H, Talano J V
Am J Cardiol. 1985 Feb 1;55(4):335-7. doi: 10.1016/0002-9149(85)90371-6.
A pericardial friction rub occurs in 6 to 16% of patients after acute myocardial infarction (AMI), but the incidence of pericardial effusion (PE) is not known. M-mode echocardiography was done 1, 3 and 5 days after AMI in 43 consecutive patients admitted within 24 hours of AMI, and PE was detected in 16 (37%). The PE was small in 7 patients, moderate in 6 and large in 3. A pericardial friction rub developed in 8 (19%), of whom only 4 had PE. Pleuritic chest pain diminished by sitting up and relieved by antiinflammatory agents developed in 12 (28%), of whom only 5 had PE. The peak creatine kinase level was significantly higher in patients with PE (1,769 +/- 1,003 U) than in those without (1,181 +/- 838 units). More patients with PE were in Killip classification II, III or IV (11 of 16 [69%] vs 9 of 27 [33%]). The presence of PE was not associated with age, site of AMI, development of Q waves, use of heparin or previous AMI. In conclusion, PE as detected by M-mode echocardiography is frequently present after AMI, and its presence is not closely associated with the occurrence of a pericardial friction rub or typical pericardial pain.
急性心肌梗死（AMI）后，6%至16%的患者会出现心包摩擦音，但心包积液（PE）的发生率尚不清楚。对43例在AMI后24小时内入院的连续患者，于AMI后1天、3天和5天行M型超声心动图检查，发现16例（37%）有PE。其中7例PE为少量，6例为中等量，3例为大量。8例（19%）出现心包摩擦音，其中仅4例有PE。12例（28%）出现因坐起而减轻、抗炎药可缓解的胸膜炎性胸痛，其中仅5例有PE。有PE的患者肌酸激酶峰值水平（1,769±1,003 U）显著高于无PE的患者（1,181±838 U）。更多有PE的患者处于Killip分级II、III或IV级（16例中的11例[69%] vs 27例中的9例[33%]）。PE的存在与年龄、AMI部位、Q波形成、肝素使用或既往AMI无关。总之，M型超声心动图检测到的PE在AMI后经常出现，其存在与心包摩擦音或典型心包疼痛的发生没有密切关联。
