心肾综合征:发生机制与防治

Cardiorenal syndrome: mechanisms, prevention and treatment

心肾综合征是指心脏或肾脏急慢性功能不全引起另一脏器的功能不全。心肾综合征目前分为5类。第1类是心功能急剧恶化引起急性肾脏损害,主要与肾血液灌注减少有关。第2类是指慢性心功能不全引起进行性慢性肾脏疾病,主要与肾素血管紧张素系统激活有关。第3类是急性肾功能恶化引起急性心功能不全,主要与肾小球滤过率减少,使水钠潴留有关。第4类是慢性肾功能不全引起心功能不全,主要与心脏前后负荷增加有关。第5类是某些病理因素引起心功能不全和肾功能不全,主要与交感神经兴奋及肾素血管紧张素系统激活有关。

Cardiorenal syndrome refers to acute or chronic cardiac or renal dysfunction may cause another organ dysfunction.Cardiorenal syndrome has 5 types.Type 1 is that abrupt worsening of cardiac function cause acute kidney injury,mainly due to lower renal perfusion.Type 2 is that chronic cardiac dysfunction cause progressive chronic kidney disease,mainly due to activation of rennin-angiotensin system.Type 3 is that abrupt worsening of renal dysfunction cause acute cardiac dysfunction,mainly due to lower renal filtration rate and water and natrium retention.Type 4 is that chronic kidney disease cause cardiac dysfunction,mainly due to increase of cardiac preload and afterload.Type 5 is that some pathologic conditions cause both cardiac and renal dysfunction,mainly due to activation of sympathetic system and rennin-angiotensin system.