血性心包积液病因分析

Etiology of pericardial hemorrhagic effusion

目的探讨血性心包积液的病因分布特点。方法选自2002年1月至2012年7月北京军区总医院东区64例和2013年4月至2014年4月北京朝阳急诊抢救中心4例,行心包穿刺明确诊断为血性心包积液患者68例。其中男性28例,女性40例,年龄范围19~87岁。按年龄将患者分为2组,老年组33例（≥60岁）和中青年组35例（18~59岁）。按性别分男性组（28例）和女性组（40例）。收集所有患者临床资料,分析血性心包积液病因分布。结果患者常见病因为恶性肿瘤（55.9%）、结核（26.4%）及非特异性心包积液（7.4%）。其他病因分别为心力衰竭、主动脉夹层及先心病等。老年组与中青年组的常见病因分布比例比较,差异无统计学意义（P均〉0.05）。男性组和女性组血性心包积液的常见病因分别为肿瘤和结核,男性与女性病因分布比例比较,差异无统计学意义（P均〉0.05）。肿瘤致血性心包积液,肺肿瘤占60.5%,妇科肿瘤13.2%,消化道肿瘤10.5%,心包间皮瘤5.3%,肾及肾上腺肿瘤5.3%,皮肤及颈部淋巴瘤各2.6%。结论肿瘤和结核为血性心包积液的主要致病因素,与年龄和性别无明显相关。

Objective To discuss the etiological distribution features of pericardia1 hemorrhagic effusion. Methods The patients （n=68, male 28, female 40 and aged from 19 to 87） were chosen from Apr. 2013 to Apr. 2014. All patients were divided into elderly group （≥60） and middle-aged and young group （18-59） according to age, and divided also male group （n=28） and female group （n=40） according to sex. The clinical materials were collected from all patients and etiological distribution of pericardial hemorrhagic effusion was analyzed. Results The common causes were malignant tumor （55.9%）, tuberculosis （26.4%） and non-specific pericardia1 effusion （7.4%）, and other causes included heart failure, aortic dissection and congenital heart disease. The difference in etiological distribution had no statistical significance between elderly group and middle-aged and young group （all P〉0.05）. The common causes were tumor and tuberculosis respectively in male group and female group and difference had no statistical significance （all P〉0.05）. The pathogenic tumors included lung tumor （60.5%）, gynecologic tumor （13.2%）, gastrointestinal tumor （10.5%）, pericardium mesothelioma （5.3%）, kidney and adrenal gland tumor （5.3%） and skin tumor and cervical lymphangioma （2.6%）. Conclusion Tumors and tuberculosis are major pathogenic causes of pericardial hemorrhagic effusion, and age and sex are not significantly correlated to pericardial hemorrhagic effusion.