Hakala M, Pettersson T, Tarkka M, Leirisalo-Repo M, Mattila T, Airaksinen J, Sutinen S
Department of Medicine, University of Oulu, Finland.
Clin Rheumatol. 1993 Jun;12(2):199-203. doi: 10.1007/BF02231526.
In order to clarify the significance of rheumatoid arthritis (RA) as a cause of cardiac compression, we scrutinized pericardiectomy files of 47 patients over a ten-year period at two university hospitals in Finland. Five patients with RA were found. All the patients with RA were men with seropositive disease and subcutaneous rheumatoid nodules. Two of the patients had pulmonary fibrosis, one had cutaneous vasculitis and three had had rheumatoid pleurisy. There was a mean delay of 10 months from the first cardiac symptom to the diagnosis of cardiac compression, the most common misdiagnosis being primarily a liver disease. On the basis of clinical and operative data, four out of the five patients had constrictive pericarditis and one had an effusive-constrictive form of the disease. The histopathological findings in all cases were consistent with chronic fibrosing pericarditis. A follow-up of seven to seventeen years of four patients has not revealed any signs of recurrent pericardial disease. Our results demonstrate that RA is an important aetiological factor for cardiac compression. The long-term outcome of this manifestation seems to be good after pericardiectomy.
为阐明类风湿关节炎（RA）作为心脏受压病因的重要性，我们仔细查阅了芬兰两家大学医院十年间47例心包切除术病例档案。发现5例RA患者。所有RA患者均为男性，患有血清阳性疾病及皮下类风湿结节。其中2例患者有肺纤维化，1例有皮肤血管炎，3例有类风湿性胸膜炎。从首次出现心脏症状到诊断为心脏受压平均延迟10个月，最常见的误诊主要为肝脏疾病。根据临床和手术资料，5例患者中有4例患有缩窄性心包炎，1例为渗出-缩窄型疾病。所有病例的组织病理学结果均符合慢性纤维性心包炎。4例患者随访7至17年，未发现心包疾病复发迹象。我们的结果表明，RA是心脏受压的一个重要病因。心包切除术后这种表现的长期预后似乎良好。
