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心衰患者由于心排血量减小和心房压力升高,神经内分泌活性交感神经系统(SNS)和肾素—血管紧张素—醛固酮(RAA)系统可发生一系列改变。在早期阶段作为代偿机制,对维持生命器官的血流灌注具有重要作用,当心力衰竭转为慢性时,部分代偿机制将产生不利影响。SNS与RAA的综合作用促进心肌细胞活性丧失、心肌细胞不良性肥大和间质纤维化,使心室重塑,导致心肌功能进一步减退。现就抗神经内分泌疗法介绍如下。
A series of changes occur in the neuroendocrine sympathetic nervous system (SNS) and renin-angiotensin-aldosterone (RAA) systems in patients with heart failure due to reduced cardiac output and atrial pressure. As a compensatory mechanism at an early stage, it plays an important role in maintaining blood flow in vital organs. When heart failure is chronic, partial compensatory mechanisms will be adversely affected. The combined effects of SNS and RAA promote the loss of cardiomyocyte activity, myocardial hypertrophy and interstitial fibrosis, remodeling ventricular remodeling, resulting in further deterioration of myocardial function. Anti-neuroendocrine therapy are introduced below.