老年人经常性心膜炎:临床和实验室特征和结果
Emanuele Bizzi1, Francesco Cavaleri1, Ruggiero Mascolo1
1Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy.
Journal of the American Geriatrics Society
|September 9, 2024
概括
复发性心膜炎在老年人中呈现的不同,通常有呼吸障碍和输液,但疼痛和发烧较少. 这一人口群体接受的NSAIDs和colchicine较少,这突出了这一群体的诊断和治疗挑战.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 老年病的医生 老年病的医生
背景情况:
- 目前关于心膜炎的指导方针缺乏针对老年人的具体数据.
- 老年人经常出现心膜炎的研究不足,临床,实验室和结局数据有限.
- 异常性复发性心膜炎在老年人群中提出了独特的挑战.
研究的目的:
- 调查年轻人和老年人之间的异常性复发性心膜炎的临床,实验室和结果差异.
- 与年轻的对照人群相比,在65岁及以上的患者中确定复发性心膜炎的特定特征.
主要方法:
- 国际多中心回顾性队列研究.
- 来自患有复发性心周炎 (异常性或心脏损伤后) 的患者的临床,实验室和结局数据的分析.
- 65岁以下患者 (对照组) 和65岁以上患者之间的比较.
主要成果:
- 老年人患慢性病,心房动和糖尿病等并发病的患病率更高.
- 呼吸障碍是老年人 (54.1%) 的主要症状,而年轻人对照组 (80.3%) 的症状是疼痛.
- 较年长的成年人表现出增加的肺部溢出 (55.6%),严重的心周溢出 (24.1%),发烧降低,白细胞数量降低.
结论:
- 患有复发性心周炎的老年人表现出明显的临床特征,包括呼吸不良,排泄和较低的炎症标志物.
- 由于老年人的非典型表现,诊断可能具有挑战性.
- 治疗模式有所不同,老年人接受的NSAIDs和粉素较少,而更多的皮质类固醇,可能是由于并发症.
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