Angomachalelis N, Hourzamanis A, Salem N, Vakalis D, Serasli E, Efthimiadis T, Triantaphyllou I
Aristotle University School of Medicine, Department of Internal Medicine, Macedonia, Greece.
Postgrad Med J. 1994;70 Suppl 1:S8-12.
Eighty-one consecutive patients, 32 males and 49 females, with biopsy-proven systemic sarcoidosis, none of whom had clinical evidence of heart disease, underwent M-mode and two-dimensional echocardiography, ECG and chest X-ray in order to investigate the frequency of sarcoid pericardial effusion. Mild or moderate size pericardial accumulations were found by echocardiography in 17 patients (21%), four males and 13 females (mean age 49.7 +/- 9.2 years). Pericardial effusion could not be correlated with clinical symptoms or physical signs, chest X-ray and ECG findings. All 17 patients with pericardial effusion were also studied by technetium-99m pyrophosphate radionuclide myocardial imaging, targeting to reveal the coincident presence of specific heart muscle disease or 'infiltrative cardiomyopathy'. The results showed abnormal scans in 13 of 14 patients with technically satisfactory scans, indicating the coincidence of sarcoid myocardial involvement in 92% of the patients with pericardial effusion, representing 16% of the total population studied. Thus, pericardial effusion in sarcoidosis should not be considered a rare condition, while concomitant presence of positive technetium-99m pyrophosphate radionuclide myocardial imaging could suggest that sarcoid pericardial effusion is often accompanied by specific heart muscle disease. This observation has not been well established previously in the literature.
81例经活检证实为系统性结节病的患者（32例男性，49例女性），均无心脏病临床证据，接受了M型和二维超声心动图、心电图及胸部X线检查，以研究结节病心包积液的发生率。超声心动图发现17例患者（21%）有轻度或中度心包积液，其中4例男性，13例女性（平均年龄49.7±9.2岁）。心包积液与临床症状、体征、胸部X线及心电图表现无相关性。对所有17例心包积液患者还进行了99m锝焦磷酸盐放射性核素心肌显像，目的是揭示是否同时存在特异性心肌疾病或“浸润性心肌病”。结果显示，在14例显像技术满意的患者中，有13例扫描结果异常，表明92%的心包积液患者同时存在结节病心肌受累，占所研究总人口的16%。因此，结节病心包积液不应被视为罕见情况，而99m锝焦磷酸盐放射性核素心肌显像呈阳性，提示结节病心包积液常伴有特异性心肌疾病。这一观察结果在以往文献中尚未得到充分证实。
