54例老年心力衰竭并发多器官衰竭的分析

• 作 者: 张绍景 丘鸿守 李健生 唐朝文 区惠琼 方惠仪
• 机 构: 广州医学院第一附属医院内科,广州医学院第一附属医院内科,广州医学院第一附属医院内科,广州医学院第一附属医院内科,广州医学院第一附属医院内科,广州医学院第一附属医院内科,
• 出 处: 广州医学院学报
• 发表日期: 1988年04期
• 关键词: 多器官衰竭 老年心力衰竭 血管加压素 出血性休克 基础心脏病 神经体液传递 去甲肾上腺素 肝衰竭 消化道出血 血管紧张素Ⅱ

本文报告60岁及60岁以上心力衰竭患者并发肺衰竭37例(指例次,下仿此),肾衰竭7例,肝衰竭6例,消化道出血4例,共54例,基础心脏病有慢性肺原性心脏病,冠心病,高血压性心脏病,慢性风湿性瓣膜病等。心衰伴多发器官衰竭死亡率明显高于没有伴发多器官衰竭者。感染、创伤、大手术或出血性休克可诱发多米诺效应,存有神经体液传递的血管活动物质,如去甲肾上腺素、乙酰胆碱、组织胺、血管加压素、血管紧张素Ⅱ、乳酸、缓激肽等循环衰竭中的有毒物质,这些物质也可在心力衰竭时出现。并发多发器官衰竭的机制未明,认识肤浅,我们提出心力衰竭并发多器官衰竭这一概念,将有助于临床警觉,和于及时诊治和预防。

This article reports the age of 60 and over 60 cases of patients with heart failure complicated by pulmonary failure in 37 cases (referring to the times, under the imitation), 7 cases of renal failure, liver failure in 6 cases, 4 cases of gastrointestinal bleeding, a total of 54 cases of basic heart disease Chronic pulmonary heart disease, coronary heart disease, hypertensive heart disease, chronic rheumatic valvular disease. Heart failure with multiple organ failure mortality was significantly higher than those without multiple organ failure. Infection, trauma, major surgery or hemorrhagic shock can induce domino effect, there are neurotransmitters of living blood vessels such as norepinephrine, acetylcholine, histamine, vasopressin, angiotensin II, lactic acid, bradykinin Peptides and other circulatory failure of toxic substances, these substances can also occur in heart failure. The mechanism of concurrent multiple organ failure is unknown and superficial. We propose that the conception of heart failure combined with multiple organ failure will contribute to clinical alertness and prompt diagnosis and treatment.