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对充血性心力衰竭(CHF)的治疗,近年来取得了很大进展。但由于平均人口寿命的提高,急性心肌梗塞(AMI)后的存活率增高等原因,这一严重综合征仍不断增多。尽管洋地黄制剂和利尿剂依然应用于临床,但普通的血管扩张剂与血管紧张素转换酶(ACE)抑制剂却越来越为人们所接受。本文旨在回顾一下轻中度 CHF 的病理生理变化及其治疗,病理生理变化有多种疾病可致左室功能不全,但其病理生理机制均相似,各种神经内分泌因素控制着心输出量。交感紧张度和循环儿茶酚胺浓度的增高,标志着心力衰竭的进一步发展。部分是由于交感神经活性增强,部分是由于肾素-血管紧张素-醛固酮(RAA)系统
In recent years, great progress has been made in the treatment of congestive heart failure (CHF). However, due to the increase of average life expectancy and the survival rate after acute myocardial infarction (AMI), the serious syndrome is still increasing. Although digitalis and diuretics continue to be used clinically, common vasodilators and angiotensin converting enzyme (ACE) inhibitors are becoming more accepted. The purpose of this article is to review the pathophysiological changes of mild to moderate CHF and its treatment. There are many kinds of diseases which can cause left ventricular dysfunction, but its pathophysiological mechanisms are similar. Various neuroendocrine factors control cardiac output. Sympathetic tension and increased circulating catecholamines mark the further development of heart failure. Partly due to the increased sympathetic activity, partly due to the renin-angiotensin-aldosterone (RAA) system