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[心肌炎]

[Myocarditis].

作者信息

Hékimian G, Combes A

机构信息

Service de réanimation médicale, groupe hospitalier Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.

Service de réanimation médicale, groupe hospitalier Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.

出版信息

Rev Med Interne. 2017 Aug;38(8):531-538. doi: 10.1016/j.revmed.2016.12.022. Epub 2017 Feb 2.

Abstract

Acute myocarditis must be considered in patients with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackie virus and adenovirus being the most frequently viruses responsible for the disease. In this setting, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. Treatment of acute myocarditis relies on conventional heart failure therapy. Immunosuppression of autoreactive myocarditis or immuno-stimulants such as interferons for chronic viral myocarditis could be of interest but their potential therapeutic role requires further investigation.

摘要

近期出现心力衰竭或心律失常的患者必须考虑急性心肌炎。暴发性心肌炎是一种独特的疾病,其特征为严重充血性心力衰竭或心源性休克突然发作,通常在类似流感的疾病之后发生,细小病毒B19、人类疱疹病毒6、柯萨奇病毒和腺病毒是导致该疾病最常见的病毒。在这种情况下,有必要尽早识别迅速进展为难治性心力衰竭的患者,并将他们立即转至在机械循环支持方面经验丰富的内科-外科中心。急性心肌炎的治疗依赖于传统的心力衰竭治疗方法。自身反应性心肌炎的免疫抑制或用于慢性病毒性心肌炎的免疫刺激剂(如干扰素)可能会有意义,但其潜在的治疗作用需要进一步研究。

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