结核性心包炎为结核杆菌所致心包脏层和壁层的炎性改变,仍是最常见的心包炎之一,至少1/3病例无肺结核病史.近年由于诊疗技术的发展,尤其是超声心动图的广泛应用,使一些患者能够早期做出诊断,本文讨论其诊治.临床特点:病情发展缓慢,多伴有发热、盗汗、易疲劳、呼吸困难,常有结核病史,常在渗出阶段或晚期发展到缩窄性心包炎以后才被发现.部分病人出现肝区疼痛不适、咳嗽、咳痰带血等,胸痛很常见,胸痛位于心前区或胸骨后,可放射至左肩及左臂,疼痛呈胸膜性,它随深呼吸,平卧位或在床上转身加重,坐位或身向前倾时减轻.在胸骨左缘第3～4肋间听诊心包摩擦音最清楚,有时也可在心前区听到 Tuberculous pericarditis caused by Mycobacterium tuberculosis pericardial visceral and parietal inflammatory changes, is still one of the most common pericarditis, at least 1/3 of cases without a history of pulmonary tuberculosis in recent years due to the development of diagnostic techniques, especially echocardiography The extensive use of the chart, so that some patients can make an early diagnosis, this article discusses the diagnosis and treatment .Clinical features: the slow progression of the disease, accompanied by fever, night sweats, fatigue, difficulty breathing, often with a history of tuberculosis, often in the oozing stage or Late development of constrictive pericarditis was discovered later.Partial patients with liver pain, cough, sputum bloody, chest pain is very common, chest pain in the anterior or sternal, radiate to the left shoulder and left arm, Pain was pleural, it takes a deep breath, supine position or turn in the bed aggravating, sitting or leaning forward to alleviate the left sternal border in the first 3 ~ 4 intercostal auscultation pericardial fricative most clearly, and sometimes can be heard in precordial area To