Saitoh H, Ezure M, Ono M, Mizuno A, Suzuki M, Ishida Y, Nagao K
Department of Cardiac Surgery, Asahi General Hospital, Japan.
Kyobu Geka. 1994 Oct;47(11):909-12.
A 32-year-old man was hospitalized because of cardiac tamponade with the thickened visceral and parietal pericardial layers. Marked high level of adenosine deaminase activity (ADA) in pericardial fluid strongly suggested the diagnosis of tuberculous pericarditis, which was later assured by positive smear and culture of the pericardial fluid for Mycobacterium tuberculosis. Before rigid adhesion of the pericardial space was established, pericardiectomy was easily performed with satisfactory improvement of the hemodynamic status and physical symptoms of the patient. The present case suggests the efficacy of early surgical intervention to tuberculous pericarditis when it shows a sign of rapid progression to constrictive pericarditis. Furthermore, high ADA in pericardial fluid might be an useful diagnostic modality for tuberculous pericarditis.
一名32岁男性因心脏压塞伴脏层和壁层心包增厚而住院。心包积液中腺苷脱氨酶(ADA)活性显著升高强烈提示结核性心包炎的诊断,随后心包液涂片和结核分枝杆菌培养阳性进一步证实了这一诊断。在心包腔形成牢固粘连之前,很容易进行心包切除术,患者的血流动力学状态和身体症状得到了令人满意的改善。本病例提示,当结核性心包炎显示出迅速进展为缩窄性心包炎的迹象时,早期手术干预是有效的。此外,心包积液中ADA水平升高可能是结核性心包炎的一种有用诊断方法。