Schultheiss H-P, Kühl U
Medizinische Klinik II, Kardiologie und Pneumonologie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin.
Dtsch Med Wochenschr. 2008 Dec;133 Suppl 8:S290-4. doi: 10.1055/s-0028-1100964. Epub 2008 Dec 15.
Myocarditis is an inflammatory disease of the cardiac muscle caused by intramyocardial infiltration of immunocompetent cells following any kind of cardiac injury. Classic myocarditis mainly occurs by the host's immune response against organisms that cause common infectious illnesses, as a manifestation of hypersensitivity or as toxic reaction to drug administration. Chronic inflammatory events may survive successful clearance of initial cardiotoxic agents, be triggered or amplified by autoimmunologic processes, or develop in the context of systemic diseases. In many cases, however, the cause of inflammatory changes, which may spread from a focus or be diffused throughout the cardiac muscle, remains unclear. Since clinical and histologic classification criteria of myocarditis alone are unsuitable for a clinically useful classification of inflammatory cardiac muscle disease, only the combination of clinical and histologic methods with immunohistochemical characterization of the inflammatory process and molecular biology virus detection ensure a reliable diagnosis and subsequent indication of specific treatment options.
心肌炎是一种心肌的炎症性疾病，由任何类型的心脏损伤后免疫活性细胞浸润心肌所致。典型心肌炎主要通过宿主针对引起常见感染性疾病的病原体的免疫反应而发生，作为超敏反应的一种表现或对药物给药的毒性反应。慢性炎症事件可能在初始心脏毒性药物成功清除后持续存在，由自身免疫过程引发或放大，或在全身性疾病的背景下发展。然而，在许多情况下，炎症变化的原因，其可能从一个病灶扩散或弥漫于整个心肌，仍不清楚。由于仅靠心肌炎的临床和组织学分类标准不适用于对炎症性心肌病进行临床有用的分类，只有将临床和组织学方法与炎症过程的免疫组织化学特征及分子生物学病毒检测相结合，才能确保可靠的诊断及后续特定治疗方案的指示。
