第2例：慢性持续性大量心包积液  

Chronic continuous massive pericardiai effusion

作　　者：黄樱硕[1] 孙颖[1] 邢云利[1] 肖瑶[1] 王宇朋[1] 唐梅[1] 李敏[1] 王翠英[1] 

机构地区：[1]首都医科大学附属北京友谊医院医疗保健中心内科,100050

出　　处：《中华老年医学杂志》2012年第7期626-629,共4页Chinese Journal of Geriatrics

摘　　要：诊治要点：心包积液的性质（渗出性、漏出性、腺苷脱氢酶、y干扰素水平等）有助于诊断，在病因不明的情况下，则可考虑诊断为非特异性心包积液或特发性心包积液。A 77-year-old man was admitted to our hospital at July 5th ,2010 with an unexplained massive pericardial effusion for 10 years. With dyspnea for one month and normal vital signs without pulsus paradoxus, other physical examination included a small amount of moist tale, normal heart sounds, jugular vein engorgement, positive hepatojugular reflux, hepatosplenomegaly and pitting edema of the extremities. The patient had a complex past history with lymph node tuberculosis, primary artertial hypertension, polycythernia vera, chronic renal insufficiency and hypothyroidism （Hashimotors thyroiditis）, and moreover, received a high dose radiation of 31p in 1967. Family history is negative. The patient had no cardiac tamponade or pericardial constriction during 10 years, he received pericardiocentesis twice, and pericardial effusion was exudative with a high proportion of monocyte. There was no evidences of tuberculosis infection, hypothyroidism, malignant tumor, severe heart failure, uremia, trauma, severe bacterial or fungus infection, chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis, indwelling catheter drainage or surgical therapy. In this rare case, the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

关 键 词：大量心包积液 慢性持续性 腺苷脱氢酶 干扰素水平 病因不明 非特异性 渗出性 漏出性 

分 类 号：R542.12[医药卫生—心血管疾病]