病毒性心肌炎后扩张型心肌病的临床认知

Clinical cognition of dilated cardiomyopathy after viral myocarditis

心肌炎后心肌病属于获得性扩张型心肌病,主要是由于机体免疫炎症反应网络以及该网络决定的由多种细胞因子组成的心脏局部微环境的异常,影响着后续的组织修复过程,最终导致心肌组织的纤维化。临床诊断需要有心肌炎自然演变为心肌病的病史或者肠道病毒RNA的持续表达或血清免疫学标志物抗心肌自身抗体阳性的证据。除了常规心力衰竭治疗方法外,针对其病因和发病机制的特异性治疗也需考虑。

Post-myocarditis cardiomyopathy belongs to acquired dilated cardiomyopathy.The main cause is the immune inflammatory response and a variety of cytokines affecting tissue repair,which eventually leads to myocardial fibrosis.Clinical diagnosis requires a history of myocarditis spontaneously evolving to cardiomyopathy,persistent expression of enterovirus RNA,or positive anti-myocardial autoantibodies.In addition to conventional heart failure treatment,specific treatments for etiology and pathogenesis need to be considered.