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老年人心包疾病的临床病理研究

A clinicopathological study on pericardial heart disease in the aged.

作者信息

Ueda K, Sugiura M

出版信息

Jpn Circ J. 1978 Feb;42(2):167-74. doi: 10.1253/jcj.42.167.

Abstract

A total of 87 cases of pericardial heart disease (73 of pericarditis and 14 of hemopericardium) among 870 consecutive autopsies of aged patients was studied. Fibrinofibrouspericarditis was found in 80.8% of pericarditis, neoplastic in 13.7% and purulent in 5.5%. Representative cases of each type of pericarditis were illustrated. Among fibrinofibrous pericarditis, idiopathic was the most common and the other causes included irradiation, myocardial infarction, renal failure, rheumatoid arthritis and hypothyroidism. Frequent association of congestive heart failure or anasarca with mild to moderate fibrinofibrous pericarditis was noted. Clinical and morphologic evidences of pulmonary tuberculosis were present in nearly one third of cases with fibrinofibrious pericarditis, but actual incidence of tuberculous pericarditis could not be determined. Incidence of clinical signs and symptoms of acute pericarditis was evaluated with the stress on the relatively high incidence of supraventricular tachyarrhythmias, especially in cases with histological evidence of sinus node involvement in aged cases.

摘要

在对870例老年患者进行的连续尸检中,共研究了87例心包心脏病(73例心包炎和14例心包积血)。在心包炎患者中,纤维蛋白性心包炎占80.8%,肿瘤性心包炎占13.7%,脓性心包炎占5.5%。对每种类型的心包炎均展示了代表性病例。在纤维蛋白性心包炎中,特发性最为常见,其他病因包括放疗、心肌梗死、肾衰竭、类风湿关节炎和甲状腺功能减退。注意到充血性心力衰竭或全身性水肿常与轻度至中度纤维蛋白性心包炎相关。在近三分之一的纤维蛋白性心包炎病例中存在肺结核的临床和形态学证据,但无法确定结核性心包炎的实际发病率。评估了急性心包炎临床体征和症状的发生率,重点关注室上性快速心律失常相对较高的发生率,尤其是在老年病例中有窦房结受累组织学证据的情况下。

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