病毒性心肌炎的发病机制

Pathogenesis of Viral Myocarditis

心肌炎是一种由多种致病因素所引起的复杂疾病。急性或慢性感染性心肌炎是由病毒、细菌、支原体或真菌所引起的心肌炎症。其中，病毒性心肌炎最为常见。肠道病毒和腺病毒所引起的心肌炎约占临床病例的20％-50％。因此，本文对病毒性心肌炎的发病机制进行了总结。病毒性心肌炎造成的心脏损伤主要有三种发病机制：（1）病毒的感染和复制直接导致的心肌损伤；（2）免疫反应；（3）生化机制。

Myocarditis is a complex disease because multiple pathogenetie factors play a role. Acute and chronic infectious myocarditis can be caused by a number of infectious agents, such as viruses, bacteria, protozoa and fungi. Among the viruses, about 20% - 50% of clinical cases are caused by enteroviruses and adenoviruses. This review focuses on the pathogenesis of viral myocarditis. Throe differont theories have been recognized to explain myocyte damage and the progression from acute myocarditis to chronic forms： direct cytotoxicity due to persistent viral infection, autoimmunity and biochemistry.