法国关于诊断和治疗复发性心膜炎的协议
Yvan Jamilloux1, Marc André2, Hélène Maillard3
1Department of Internal Medicine, CeRéMAIA, Croix-Rousse Hospital, Hospices Civils de Lyon (HCL), University of Lyon 1, Lyon, France.
概括
复发性心膜炎涉及到心脏的反复炎症.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 临床实践指南 临床实践指南
背景情况:
- 经常性心周炎是由心周炎症的重复发作所定义的.
- 诊断包括临床症状,成像 (心声学,MRI) 和炎症标志物,如C反应蛋白 (CRP).
- 确定原因,通常是异常,但可能是自身免疫性,自身炎症性或传染性,至关重要.
研究的目的:
- 为诊断和管理复发性心膜炎提供明确,协调和更新的指导.
- 改善患有复发性心膜炎的患者的长期护理.
- 建立一个法国诊断和管理协议.
主要方法:
- 对症状的临床评估 (胸痛,摩擦擦).
- 诊断成像包括心声回声和MRI.
- 对炎症标志物 (CRP) 的实验室测试.
主要成果:
- 胆固醇是主要治疗方法,使用3-6个月或更长时间.
- 推使用NSAIDs或阿司匹林来治疗与科尔奇辛一起发生的急性发作.
- 一般避免使用皮质类固醇;在耐火病例中考虑使用IL-1抑制剂 (anakinra, rilonacept).
结论:
- 管理重点是通过协调的专业护理来预防复发.
- 长期随访包括监测症状,CRP和生活质量.
- 逐渐停止治疗和患者教育对于长期成功至关重要.
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