Objective To discuss the etiological distribution features of pericardial hemorrhagic effusion. Methods The patients (n=68, male 28, female 40 and aged from 19 to 87) were chosen from Apr. 2013 to Apr. 2014. All patients were divided into elderly group (≥60) and middle-aged and young group (18-59) according to age, and divided also male group (n=28) and female group (n=40) according to sex. The clinical materials were collected from all patients and etiological distribution of pericardial hemorrhagic effusion was analyzed. Results The common causes were malignant tumor (55.9%), tuberculosis (26.4%) and non-specific pericardial effusion (7.4%), and other causes included heart failure, aortic dissection and congenital heart disease. The difference in etiological distribution had no statistical significance between elderly group and middle-aged and young group (all P>0.05). The common causes were tumor and tuberculosis respectively in male group and female group and difference had no statistical significance (all P>0.05). The pathogenic tumors included lung tumor (60.5%), gynecologic tumor (13.2%), gastrointestinal tumor (10.5%), pericardium mesothelioma (5.3%), kidney and adrenal gland tumor (5.3%) and skin tumor and cervical lymphangioma (2.6%). Conclusion Tumors and tuberculosis are major pathogenic causes of pericardial hemorrhagic effusion, and age and sex are not significantly correlated to pericardial hemorrhagic effusion.%目的：探讨血性心包积液的病因分布特点。方法选自2002年1月至2012年7月北京军区总医院东区64例和2013年4月至2014年4月北京朝阳急诊抢救中心4例，行心包穿刺明确诊断为血性心包积液患者68例。其中男性28例，女性40例，年龄范围19~87岁。按年龄将患者分为2组，老年组33例（≥60岁）和中青年组35例（18~59岁）。按性别分男性组（28例）和女性组（40例）。收集所有患者临床资料，分析血性心包积液病因分布。结果患者常见病因为恶性肿瘤（55.9%）、结核（26.4%）及非特异性心包积液（7.4%）。其他病因分别为心力衰竭、主动脉夹层及先心病等。老年组与中青年组的常见病因分布比例比较，差异无统计学意义（P均＞0.05）。男性组和女性组血性心包积液的常见病因分别为肿瘤和结核，男性与女性病因分布比例比较，差异无统计学意义（P均＞0.05）。肿瘤致血性心包积液，肺肿瘤占60.5%，妇科肿瘤13.2%，消化道肿瘤10.5%，心包间皮瘤5.3%，肾及肾上腺肿瘤5.3%，皮肤及颈部淋巴瘤各2.6%。结论肿瘤和结核为血性心包积液的主要致病因素，与年龄和性别无明显相关。
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