The late appearance of chronic pericardial disease in patients treated by radiotherapy for Hodgkin's disease.
The late appearance of chronic pericardial disease in patients treated by radiotherapy for Hodgkin's disease.
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DOI：
10.7326/0003-4819-94-3-338
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发表时间：
1981-03
影响因子：
39.2
通讯作者：
M. M. Applefeld-M.;J. Cole;S. H. Pollock;F. Sutton;R. Slawson;R. Singleton;P. Wiernik
中科院分区：
文献类型：
--
作者：
M. M. Applefeld-M.;J. Cole;S. H. Pollock;F. Sutton;R. Slawson;R. Singleton;P. Wiernik
霍奇金病放射治疗后 53 至 124 个月（平均 88 个月）的 9 名患者中发现了放射诱发的慢性心包疾病。根据异常心脏血流动力学是否发生在液体挑战之前或之后，患者被认为患有缩窄性心包炎（第一组）或隐匿性缩窄性心包炎（第二组）。这些组之间在各种放疗数据、化疗的使用或诊断为慢性心包疾病时的治疗间隔时间上没有差异。在心导管插入术之前，没有一致的非侵入性变量支持辐射诱发的慢性心包疾病的诊断。 4 名患者接受了心包切除术。 4名接受手术的患者中，有2名获得了良好的手术效果；第三名患者术后 4 个月死于药物引起的粒细胞减少症；第四位患者术后18个月出现持续性内脏缩窄性心包炎。对辐射引起的慢性心包疾病的原因进行了推测，并给出了治疗建议。
Radiation-induced chronic pericardial disease was recognized in nine patients 53 to 124 months (mean, 88 months) after radiotherapy for Hodgkin's disease. Depending on whether abnormal cardiac hemodynamics occurred before or after a fluid challenge, patients were considered to have either constrictive pericarditis (Group I) or occult constrictive pericarditis (Group II). There were no differences between these groups in various radiotherapy data, the use of chemotherapy, or the interval after treatment when the diagnosis of chronic pericardial disease was made. There were no consistent noninvasive variables to support the diagnosis of radiation-induced chronic pericardial disease before cardiac catheterization. Four patients underwent pericardiectomy. Two of the four operated patients had an excellent surgical result; a third patient died 4 months postoperatively of drug-induced granulocytopenia; the fourth patient has persistent visceral constrictive pericarditis 18 months after surgery. Speculation over the causes of radiation-induced chronic pericardial disease is made and our recommendations for its treatment given.