Brehm M, Rellecke P, Strauer B E
Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine Universität, Moorenstrasse 5, 40225, Düsseldorf, Deutschland.
Internist (Berl). 2008 Jan;49(1):27-33. doi: 10.1007/s00108-007-1949-z.
As systemic immunological disorders, internal diseases in gastroenterology, rheumatology and infectiology can, in addition to the bowels, potentially involve the musculo-skeletal system, the immunological system and heart structures. All structures and functions of the heart can be affected. Pericarditis in lupus erythematosus and chronic inflammatory bowel disease, myocarditis in HIV infection and lyme disease are examples of cardiac manifestations of internal diseases. The pathogenetic causes can be manifold, such as direct cytotoxic effects in HIV or Borrelia burgdorferi infections, induced vasculitis and local activation of coagulation factors as in lupus erythematosus or chronic inflammatory bowel disease. Improved treatment options have led to more long-lasting courses of internal diseases, such as in infectious diseases, lupus erythematosus and chronic inflammatory bowel disease, thus cardiovascular complications such as pericarditis and myocarditis gain increasing importance as a consequence of chronic disease and therapy-related damage.
作为全身性免疫疾病,胃肠病学、风湿病学和传染病学中的内科疾病除累及肠道外,还可能累及肌肉骨骼系统、免疫系统和心脏结构。心脏的所有结构和功能都可能受到影响。红斑狼疮和慢性炎症性肠病中的心包炎、HIV感染和莱姆病中的心肌炎都是内科疾病心脏表现的例子。致病原因可能多种多样,如HIV或伯氏疏螺旋体感染中的直接细胞毒性作用、红斑狼疮或慢性炎症性肠病中诱导的血管炎和凝血因子的局部激活。治疗选择的改善导致内科疾病病程延长,如传染病、红斑狼疮和慢性炎症性肠病,因此,作为慢性病和治疗相关损害的后果,心包炎和心肌炎等心血管并发症变得越来越重要。