心肌梗死后心力衰竭防治进展

Progress in prevention and treatment of heart failure after myocardial infarction

心力衰竭是全球重要的公共卫生问题，其中冠心病是导致心衰的首位病因。国外研究中心梗后心衰的发病率和病死率正逐年改善。但近十年来我国急性心肌梗死发病率剧增，心梗发病率增加了5倍，而院内病死率并没有下降。心梗后机体通过心肌坏死及凋亡、炎症反应、神经体液系统过度激活等多途径导致心室重构引起心力衰竭。心肌梗死发生后可通过各项检查评估患者预后。除指南外针对心梗后心衰的防治药物，干细胞移植和基因治疗有望成为新的治疗方法。终末期心衰辅助装置的应用明显提升患者生活质量。

Heart failure is one of the most important public health problems in the world. Coronary heart disease is the leading cause of heart failure. The morbidity and mortality of heart failure after treatment in overseas researches are improving year by year. In the past ten years, the incidence of acute myocardial infarction in China has increased rapidly, which has in- creased by five times, while the in-hospital mortality has not decreased. The body after myocardial infarctionleads to ventricular remodeling and heart failurethroughmany ways, including myocardial cell death, inflammation and neurohumoral activation. After myocardial infarction, the patient＇s prognosis can be evaluated by various examinations. In addition to the medicine in guidelines, stem cell transplantation and gene therapy are expected to be new therapies for heart failure after myocardial infarc- tion. The use of assistive devices for end-stage heart failure significantly improved the quality of life in patients