HEART IN RHEUMATOID ARTHRITIS (RHEUMATOID DISEASE) - A CLINICAL AND PATHOLOGICAL STUDY OF 62 CASES
HEART IN RHEUMATOID ARTHRITIS (RHEUMATOID DISEASE) - A CLINICAL AND PATHOLOGICAL STUDY OF 62 CASES
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DOI：
10.7326/0003-4819-58-1-102
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发表时间：
1963-01-01
影响因子：
39.2
通讯作者：
LEBOWITZ, WB
中科院分区：
文献类型：
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作者：
LEBOWITZ, WB
类风湿患者尸检心脏病发生率明显高于对照组。高血压和高血压性心脏病在类风湿患者中的发生率明显较低。动脉粥样硬化性心脏病和心肌梗死，风湿性心脏病也遇到类似的频率在类风湿性和对照组患者。非风湿性钙化性主动脉瓣狭窄和瓣膜硬化在类风湿患者中明显更常见。本文报告34例类风湿性心脏病的心脏病变，与风湿性心脏病不同，与并发症或治疗无关。其中肉芽肿2例，心包炎18例，心肌炎12例，大动脉炎13例，慢性心内膜炎4例，瓣膜纤维化15例。总体发生率以及单个病变的发生率均显著高于对照组。这些病变的性质被定义，并得出结论，他们是类风湿过程的多变表现。代表性病例报告说明了临床表现的病变。这些病变的尸检发生率大于归因于它们的临床表现的发生率。然而，在17例有临床心脏病的类风湿患者中，尸检时唯一的心脏病变是类风湿性疾病，其中8例死于疾病。这些数据表明，“类风湿性心脏病”不仅仅是一种病理性的好奇心。
The autopsy incidence of heart disease in rheumatoid patients was significantly higher than in the control group. Hypertension and hypertensive heart disease was significantly less frequent in rheumatoid patients. Atherosclerotic heart disease and myocardial infarction, and also rheumatic heart disease were encountered with similar frequency in rheumatoid and control patients. Non-rheumatic calcific aortic stenosis and valvular sclerosis were significantly more frequent in rheumatoid patients. Cardiac lesions, dissimilar to those of rheumatic heart disease, which could not be correlated with intercurrent illness or therapy, were found in 34 rheumatoid patients. These included granu-lomata in 2; pericarditis in 18; myocarditis in 12; arteritis in 13; chronic endocarditis in 4 and valvular fibrosis in 15 patients. The overall incidence as well as the incidence of the individual lesions was sig-nigicantly more frequent than in the control group. The nature of these lesions was defined, and it was concluded that they were protean manifestations of the rheumatoid process. Lesions which were clinically manifest were illustrated by representative case reports. The post-mortem incidence of these lesions was greater than the incidence of clinical manifestations attributable to them. Nevertheless, in 17 rheumatoid patients with clinical cardiac disease, the only cardiac lesions at autopsy were those of rheumatoid disease, and 8 of these patients died of their disease. These data demonstrate that "rheumatoid heart disease" is not merely a pathological curiosity.