Friman G, Fohlman J
Department of Infectious Diseases, Uppsala University Hospital, Sweden.
Scand J Infect Dis Suppl. 1993;88:7-10.
The enteroviruses, especially the Coxsackie B viruses, predominate as causative agents in myopericarditis and may be involved in the pathogenesis of dilated cardiomyopathy. Some studies suggest that these and other viruses might be implicated even in atherosclerosis and myocardial infarction. True incidence data of myopericarditis in the population at large are hardly feasible, since the disease is most often mild or subclinical. The long-term prognosis is favorable even in a majority of hospital-treated patients. A recent histopathological study of unselected autopsy cases employing the "Dallas criteria" for a diagnosis shows a myopericarditis incidence of 1.06 per cent. A link between myopericarditis and dilated cardiomyopathy is supported by findings of enteroviral RNA in biopsies and explanted hearts in the latter condition. A partly new panorama of viral heart disease is emerging in heart transplant recipients and AIDS patients.
肠道病毒，尤其是柯萨奇B组病毒，是心肌炎的主要病原体，可能参与扩张型心肌病的发病机制。一些研究表明，这些病毒和其他病毒甚至可能与动脉粥样硬化和心肌梗死有关。由于该疾病大多症状轻微或为亚临床症状，因此很难获得普通人群中心肌炎的真实发病率数据。即使在大多数接受住院治疗的患者中，其长期预后也较好。最近一项对未经选择的尸检病例进行的组织病理学研究，采用“达拉斯标准”进行诊断，结果显示心肌炎的发病率为1.06%。在扩张型心肌病患者的活检组织和移植心脏中发现肠道病毒RNA，这支持了心肌炎与扩张型心肌病之间的联系。在心脏移植受者和艾滋病患者中，正在出现一幅部分全新的病毒性心脏病图景。
