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嗜酸性粒细胞性心肌炎的诊断与治疗

Diagnosis and treatment of eosinophilic myocarditis.

作者信息

Zhong Zezhong, Yang Zicong, Peng Yiming, Wang Lei, Yuan Xuming

机构信息

Department of Cardiology, Liuyang People's Hospital, Nanhua University, Hunan Province, 410300, China.

People's Hospital of Guangxi Zhuang Autonomous Region, 530021, China.

出版信息

J Transl Autoimmun. 2021 Sep 2;4:100118. doi: 10.1016/j.jtauto.2021.100118. eCollection 2021.

Abstract

Eosinophilic myocarditis is a type of inflammatory cardiomyopathy characterized by eosinophilic infiltration into myocardial tissue. The accurate myocarditis incidence rate is difficult to determine because of the clinical limitations of an endomyocardial biopsy. The primary pathogenesis of eosinophilic myocarditis is the release of related substances by eosinophils, leading to cell membrane damage and cell destruction. However, evidence suggests that specific genes play a role in myocarditis development.As CMR imaging availability increases, the diagnosis rate of eosinophilic myocarditis will increase. The diagnosis of myocarditis mainly depends on an endocardial biopsy. Glucocorticoids can relieve patients' symptoms, but the early use of steroids may prevent intermediate disease stage development (i.e., thrombonecrosis and fibrosis with wall thrombosis). Anticoagulant therapy may also affect disease development. In addition to routine follow-up, a regular myocardial biopsy should be considered for discharged patients, if possible.

摘要

嗜酸性粒细胞性心肌炎是一种炎症性心肌病,其特征是嗜酸性粒细胞浸润心肌组织。由于心内膜心肌活检的临床局限性,准确的心肌炎发病率难以确定。嗜酸性粒细胞性心肌炎的主要发病机制是嗜酸性粒细胞释放相关物质,导致细胞膜损伤和细胞破坏。然而,有证据表明特定基因在心肌炎的发展中起作用。随着心脏磁共振成像(CMR)的可用性增加,嗜酸性粒细胞性心肌炎的诊断率将会提高。心肌炎的诊断主要依赖于心内膜心肌活检。糖皮质激素可以缓解患者症状,但早期使用类固醇可能会阻止疾病发展到中间阶段(即伴有壁血栓形成的血栓坏死和纤维化)。抗凝治疗也可能影响疾病发展。除了常规随访外,对于出院患者,如果可能的话,应考虑定期进行心肌活检。

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