利钠肽系统与肾素-血管紧张素-醛固酮系统在心力衰竭中交互作用

Interactions between the Natriuretic Peptides System and the Renin-angiotensin-aldosterone System in Heart Failure

慢性心力衰竭是以高发病率、高入院率及高死亡率为特征的临床综合征,也是各种心血管疾病发展的终末阶段。神经激素系统的激活在心力衰竭病理生理中起着关键作用,其以肾素-血管紧张素-醛固酮系统(RAAS)、交感神经系统(SNS)及利钠肽系统(NPs)为主要组成部分。在心衰的病理生理中,NPs与RAAS存在交互作用,其对于与心功能不全相关的血液动力学改变与组织重塑起重要的作用,并且最终可导致心衰的恶化。因此,能够同时作用于RAAS与NPs,并且能够纠正两者间调节紊乱的干预措施,对于慢性心衰的治疗将具有良好的疗效。本文将主要对RAAS、NPs及NPs与RAAS的交互作用在心衰中的病理生理作用进行综述,并展望针对NPs与RAAS的交互作用的临床应用前景。

Heart failure （HF）,a clinical syndrome with high prevalence,hospital readmission rate and mortality,is the final common pathway for a variety of cardiovascular diseases.The neurohormonal system plays a vital role in the pathophysiology of HF,which mainly comprise the sympathetic nervous system （SNS）,the renin-angiotensin-aldosterone system （RAAS） and the natriuretic peptides system （NPs）.There is relevant interactions between NPS and RAAS in the pathophysiology of HF,which is crucial for both hemodynamic and tissue remodeling associated to ventricular dysfunction,leading to advanced deterioration of heart failure.Therapies targeting and resetting both RAAS and NPs seem to be promising for the treatment of chronic HF.The present review will mainly summarize pathophysiological roles of HF underlying RAAS,NPs and the interaction between RAAS and NPs alongside with the interaction for a better prospect.