Moreno R, Villacastín J P, Bueno H, López de Sá E, López-Sendón J L, Bobadilla J F, García-Fernández M A, Delcán J L
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Cardiology. 1997 Sep-Oct;88(5):397-400. doi: 10.1159/000177367.
Pericardial effusion (PE) is frequently found in patients infected with the human immunodeficiency virus (HIV), but its clinical significance remains unclear. Our purpose was to study the manifestations of HIV-infected patients with PE and the coexistence of these manifestations with other echocardiographic abnormalities, compared with patients without PE.
We reviewed 141 HIV-infected patients in whom echocardiographic study was performed. We studied their epidemiological, clinical, hematological, immunological, electrocardiographic (ECG) and echocardiographic characteristics and their in-hospital outcome.
Patients with PE (n = 55), compared with those without PE (n = 86), were more often clinical stage C and immunological stage 3, had left-ventricular dysfunction and right-ventricular dilatation more frequently, and had been diagnosed as HIV-positive for a longer time. Seven patients with moderate to severe PE developed cardiac tamponade. Compared with patients with small PE (n = 34), those with moderate to large PE (n = 21), had pericardial rub, ECG repolarization abnormalities consistent with pericarditis, immunological stage 3, left-ventricular dysfunction and right-ventricular dilatation more frequently. In 3 patients, cardiac tamponade disappeared after anti-tuberculous therapy; in 3 cases, pericardial drainage was performed (anti-tuberculous therapy was not attempted); 1 patient with cardiac tamponade was not drainaged because he was a terminal patient with an extensive lymphoma.
PE in HIV-infected patients is associated with (1) advanced stages of infection, and (2) left-ventricular dysfunction and right-ventricular dilatation; (3) presence of pericardial rub and ECG alterations consistent with pericarditis suggests the existence of moderate to large PE.
心包积液（PE）在感染人类免疫缺陷病毒（HIV）的患者中很常见，但其临床意义仍不明确。我们的目的是研究合并PE的HIV感染患者的表现，以及这些表现与其他超声心动图异常的共存情况，并与无PE的患者进行比较。
我们回顾了141例接受超声心动图检查的HIV感染患者。我们研究了他们的流行病学、临床、血液学、免疫学、心电图（ECG）和超声心动图特征以及他们的住院结局。
与无PE的患者（n = 86）相比，有PE的患者（n = 55）更常处于临床C期和免疫3期，左心室功能障碍和右心室扩张更常见，且被诊断为HIV阳性的时间更长。7例中重度PE患者发生了心脏压塞。与小量PE患者（n = 34）相比，中大量PE患者（n = 21）心包摩擦音、与心包炎一致的ECG复极异常、免疫3期、左心室功能障碍和右心室扩张更常见。3例患者抗结核治疗后心脏压塞消失；3例进行了心包引流（未尝试抗结核治疗）；1例心脏压塞患者因是广泛淋巴瘤晚期患者未进行引流。
HIV感染患者的PE与（1）感染晚期，（2）左心室功能障碍和右心室扩张有关；（3）心包摩擦音和与心包炎一致的ECG改变提示存在中大量PE。
