射血分数减低型心力衰竭的病情进展机制与治疗

Disease progress mechanism and treatment of heart failure with reduced ejection fraction

临床上,射血分数减低型心力衰竭(HFrEF)的病情以进行性心功能下降为特征,伴随着患者反复住院、症状加重、生活质量显著恶化,并给患者家庭带来巨大的经济负担。并且随着时间的推移,以前被用来改善患者预后的药物疗效逐渐下降。即使采用当前最先进的医疗手段,患者的死亡率仍呈上升趋势。临床上,HFrEF患者更容易出现对神经激素药物的不耐受,以及对利尿剂高需求量和利尿剂抵抗的心肾综合征,神经激素激活可能是其进展的主要决定因素。本文就HFrEF的病情进展的机制及治疗方案作一综述。

Clinically,the condition of heart failure with reduced ejection fraction(HFrEF)is characterized by progressive decline of cardiac function,accompanied by repeated hospitalization,aggravation of symptoms,obvious deterioration of quality of life,and a huge economic burden on patients'family.And as time goes,therapeutic effect of drugs that used to improve prognosis gradually decrease.Even with the use of the most advanced medical measures,the mortality of patients remains rising.Clinically,HFrEF patients are more likely to occur intolerance to neurohormonal drugs,high request dose of diuretics and diuretic-resistant cardiorenal syndrome,thus neurohormonal activation may be a main determining factor of its progression.The present article reviews the disease progress mechanism and therapeutic program of HFrEF.