缩窄性心包炎诊断技术的研究进展  

Diagnostic Techniques for Constrictive Pericarditis

作　　者：夏雪 周建中[1] XIA Xue;ZHOU Jianzhong(Department of Cardiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院心内科,重庆400016

出　　处：《心血管病学进展》2024年第7期608-611,621,共5页Advances in Cardiovascular Diseases

摘　　要：缩窄性心包炎(CP)是由于各种原因导致心包的增厚、粘连、钙化和纤维化等,致使心脏舒张功能受限,早期出现右心衰竭的症状和体征,若不经及时治疗,可导致全心衰竭等不良心血管事件的发生。由于症状非特异性,起病隐匿,CP常被误诊为其他心血管或非心血管疾病,如冠心病、限制型心肌病和淤血性肝病等。现阶段对于CP的诊断集中在无创影像技术上,超声心动图是首要的检查方法,CT和磁共振成像可显示心包解剖结构及评估心包炎症等;当无创技术不能明确诊断时,可监测血流动力学以及监测因CP所致静脉系统压力升高测得的外周静脉压以辅助诊断;而以上均无法明确时,可通过手术行病理活检明确诊断。CP的诊断具有挑战性,容易被漏诊和误诊,为此现综述该病的诊断技术现状及进展。Constrictive pericarditis(CP)is caused by various causes of pericardial thickening,adhesions and fibrosis,resulting in limited diastolic function of the heart,so that the symptoms and signs of right heart failure appear in the early stage of CP.If not treated in time,it can lead to adverse cardiovascular events such as total heart failure.Due to non-specific symptoms and insidious onset,CP is often misdiagnosed as other cardiovascular or non-cardiovascular diseases,such as coronary heart disease,restrictive cardiomyopathy,and congestive liver disease.Now the diagnosis of CP focuses on non-invasive imaging techniques,for example,echocardiography is the primary examination method,CT and magnetic resonance imaging can show the anatomical structure of the pericardium and assess pericardial inflammation.When the non-invasive techniques fail to make a clear diagnosis,hemodynamics can be monitored and peripheral venous pressure measured for elevated venous pressure due to CP can be used to aid diagnosis.If none of the above can be determined,the diagnosis can be confirmed by surgical pathological biopsy.The diagnosis of CP is challenging,and it is easy to be missed or misdiagnosed.Therefore,this article reviews the current status and progress of diagnostic techniques for this disease.

关 键 词：缩窄性心包炎 诊断 外周静脉压 无创影像学 

分 类 号：R542.11[医药卫生—心血管疾病]