心功能不全时胃肠道功能的保护及并发症的处理

Protection of gastrointestinal function and treatment for complications in patients with congestive heart failure

充血性心力衰竭(congestive heart failure,CHF)是多器官受累的临床综合征,其中胃肠道系统功能的改变已引起人们广泛关注。当心力衰竭发生时,胃肠道低灌注,胃肠黏膜缺血缺氧,肠道屏障功能障碍,出现肠道细菌移位和肠源性内毒素血症。内毒素激活体内细胞因子和炎性介质的释放,可进一步引起肠道屏障功能障碍并加重心肌细胞损害,从而形成恶性循环,引起心力衰竭进一步恶化。对心力衰竭并发胃肠道功能紊乱进行早期干预与治疗,对改善心力衰竭症状,延缓心力衰竭进一步恶化具有良好效果。

Congestive heart failure（CHF） is a clinical syndrome involving multiple organs, in which changes of gastrointestinal system function have aroused widespread concern. Gastrointestinal tract will prime lowly, gastrointestinal mucosa will have ischemia and hypoxia, intestinal barrier will have dysfunction, and intestinal bacteria will shift and intestinal endotoxemia will appear when heart failure occurs. Endotoxin activates the release of cytokines and inflammatory mediators in vivo, which can further cause intestinal barrier dysfunction and increase myocardial damage, thus forming a vicious circle, further deteriorating heart failure. Research at home and abroad has found, early intervention and treatment for heart failure combined with gastrointestinal dysfunction has a good effect in improving heart failure symptoms and preventing heart failure progress.