Adler Y, Aharon A, Zandman-Goddard G
Medical Dept. B, Chaim Sheba Medical Center, Tel Hashomer.
Harefuah. 1994 Mar 1;126(5):248-9, 304.
The incidence of recurrence of pericarditis is about 15-32%. The most common causes include trauma, myocardial infarction, and pericardiectomy. The optimal treatment to prevent recurrence has not been fully established. Possible modalities include nonsteroid anti-inflammatory drugs, corticosteroids, azathioprine, and pericardiectomy. We describe a 19-year-old man with osteogenic sarcoma who developed recurrent pericarditis despite treatment with prednisone and pericardiocentesis. Colchicine was administered in an effort to prevent further bouts of pericarditis. During the acute phase he was treated with a combination of prednisone, 60 mg/day, and colchicine, 1 mg/day. The dose of prednisone was then lowered to 5 mg/day. There was a recurrence when he stopped taking colchicine due to abdominal discomfort. On renewal of treatment there were no further attacks during a follow-up of 16 months. We confirm the results of a previous trial which showed that colchicine may be beneficial in preventing the recurrence of pericarditis. However, these results need corroboration by a large double-blind study.
心包炎复发的发生率约为15%-32%。最常见的病因包括外伤、心肌梗死和心包切除术。预防复发的最佳治疗方法尚未完全确立。可能的治疗方式包括非甾体抗炎药、皮质类固醇、硫唑嘌呤和心包切除术。我们描述了一名19岁的骨肉瘤男性患者，尽管接受了泼尼松和心包穿刺术治疗，但仍发生了复发性心包炎。给予秋水仙碱以预防心包炎的进一步发作。急性期，他接受了泼尼松（60毫克/天）和秋水仙碱（1毫克/天）联合治疗。随后泼尼松剂量降至5毫克/天。当他因腹部不适停止服用秋水仙碱时出现了复发。重新治疗后，在16个月的随访期间未再发作。我们证实了先前一项试验的结果，该结果表明秋水仙碱可能有助于预防心包炎复发。然而，这些结果需要大型双盲研究予以证实。
