充血性心力衰竭的选择性治疗

• 作 者: 刘治全
• 机 构: 西安医科大学第一附属医院内科
• 出 处: 临床荟萃
• 发表日期: 1988年02期
• 关键词: 充血性心力衰竭 选择性治疗 舒张性 β受体阻滞剂 代偿机制 收缩性 心功能 心室收缩功能 代偿作用 正性肌力药物

近年来随着对慢性充血性心力衰竭(心衰)的代偿机制、心肌收缩和舒张性能等诸方面的深入研究,在一些概念上有了新的认识,从而为心衰的治疗提出了新的问题。 交感神经对心衰代偿作用的重新估价 长期以来一直认为交感神经系统的激活藉以加强衰竭心肌的收缩性,是一个重要的代偿机制。近年来的研究证明,心肌长期暴露于儿茶酚胺并不能使衰竭心肌始终得到有益的效应,相反会使心功能进一步恶化。β受体阻滞剂有可能逆转这些不利影响,从而使心室收缩功能得到改善。

In recent years, with the deep research on compensatory mechanism of chronic congestive heart failure (heart failure), myocardial contractility and diastolic function, etc., some new concepts have been given to new ideas for the treatment of heart failure The problem. The reevaluation of the compensatory role of sympathetic nerves in heart failure has long been considered to activate the sympathetic nervous system in order to enhance the contractility of failing myocardium is an important compensatory mechanism. In recent years, studies have shown that long-term myocardial exposure to catecholamines do not always have a beneficial effect on myocardial failure, but will further deteriorate cardiac function. Beta blockers are likely to reverse these adverse effects, resulting in improved ventricular systolic function.