Analysis of Pericardial Fluid in Patients with Cardiac Disease

심장질환환자에서 심막액의 분석

  • 김종원 (부산대학교 의과대학 흉부외과학 교실) ;
  • 황수희 (부산대학교 의과대학 흉부외과학 교실)
  • Published : 1996.12.01

Abstract

Few observation have been made on the pericardial pressure and little is known about the composition of he pericardial fluid. So we studied the basic qualitative and quantitative analysis of the pericardial fluid in the patients with cardiac disease either congenital heart diasese(group A) or acquired heart disease(group B). The pressure of the pericardial cavity was measured by the method of open tipped water filled small polyethylene catheter connecting to the standardized monitor, which was introduced into pericardium of the patients who were performed pericardial incision for the heart or pericardial surgery. All of the data was compared to the simultaneously checked hematologic value of the same patient. The mean pressure of the pericardial cavity was 2.4mmHg and the amount of the pericardial fluid was 13cc/m2 of body surface for the group A and 17.7cc for the group B. And the cell count was 138$\pm$l16/1 in group A and 230$\pm$135/1 in group B and the pH was 7.83$\pm$0.40 in group A. 7.80$\pm$0.52 in group B. Pericardial fluid revealed satisfactically significant alkaline pH than plasma. The fundamental electrolyte, Wa+, K+, Cl and glucose were identical to the hematologic values of the same patient, but the protein concentration was 2.Bg/dL for group A and 3.Ig/dL for group B heart disease and those were remarkable low concentration compared to the hematologic value of the same patient. LDH and amylase were identical to the value of the serum of the same patient, but the concentration of LDH of group B was slightly higher than that of the group A.

심낭의 질환은 심혈관계에서 중요한 부분이지만 심낭압이나 심낭저류액의 조성에 대해서 연구된 바 는 거의 없다. 저자는 선천성 심장병(group A) 이나 후천성 심장병을(group B)을 가지고 있는 심장질환 환자에서 심장저류액의 정량, 정성적 분석에 대한 연구를 시행하였다. 심낭내압을 측정하기 위해 개심술 혹은 심장절개를 시행한 환자에게서 심방절개전 물을 채운 작은 18G polyethylene catheter를 심방내로 삽입하고 표준화된 monitor에 연결하여 측정하였다. 모든 수치는 동일 환자에게서 동시에 채취한 혈액에서 측정된 자료와 비교하여 분석하였다. 평균 심낭내압은 2.4mmHg였고 심낭저류액의 양은 group A에서 체표면적당 13cc, group B에서 17. 7cc였다. 그리고 세포수는 group A에서 138$\pm$l16/1, group B에서 230$\pm$ 13511였고 산도는 group A에서 2.Bg/dL, group B에서 3.IgldL로 혈장단백질농도에 비해 현저하게 낮은 농도를 나타냈다. LDH와 amylase는 혈청과 차이가 없었으나 group B에서 group A에 비해 야간 높은 수치를 보였다.

Keywords

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