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先天性心脏病的代偿期与失代偿期存在着不同程度的交感神经系统的激活和神经内分泌系统的紊乱,以及纤溶系统功能失衡。因此多种缩血管物质如血管紧张素Ⅱ(Ang II)、内皮素-1(ET-1)、去甲肾上腺素(NA)等生成与释放增加,而舒血管物质如一氧化碳(NO)、利尿钠肽等生成或作用降低。这些缩血管物质不仅加剧血流动力学的紊乱,而且某些物质还可以直接作用于心脏,损伤心肌细胞,诱导心肌细胞肥大与凋亡,促使先天性心脏病(CHD)患者的病情加重;同时CHD患者存在血管内皮细胞和血小板的功能障碍及凝血、抗凝系统的异常,可导致血液处于血栓前状态。而介入治疗(CHD封堵术)后,心内左向右分流被完全阻断,因此,CHD患者的交感神经系统和神经内分泌系统,以及纤溶系统的功能逐渐恢复正常。
There are varying degrees of activation of the sympathetic nervous system and neuroendocrine system disorders, as well as the functional imbalance of the fibrinolytic system in compensatory and decompensated congenital heart disease. Therefore, a variety of vasoconstrictors such as angiotensin II (Ang II), endothelin-1 (ET-1), norepinephrine (NA) and other generation and release increased, and vasodilators such as carbon monoxide (NO) Natriuretic peptide generation or the role of reduced. These vasoconstrictors not only exacerbate hemodynamic disturbances, but also act directly on the heart, damaging cardiomyocytes, inducing cardiomyocyte hypertrophy and apoptosis, and contributing to the progression of patients with congenital heart disease (CHD); meanwhile, CHD patients with vascular endothelial cells and platelet dysfunction and coagulation, anticoagulation system abnormalities, can lead to blood in a prothrombotic state. Interventional therapy (CHD occlusion), the left heart to the right shunt was completely blocked, therefore, CHD patients with sympathetic and neuroendocrine system, and fibrinolytic system function gradually returned to normal.