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  • 高渊,韩林*.自主神经干预在心力衰竭治疗中的进展[J].第二军医大学学报,2020,41(1):69-74    [点击复制]
  • GAO Yuan,HAN Lin*.Autonomic nervous intervention in treatment of heart failure: recent progress[J].Acad J Sec Mil Med Univ,2020,41(1):69-74   [点击复制]
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自主神经干预在心力衰竭治疗中的进展
高渊,韩林*
0
(海军军医大学(第二军医大学)长海医院心血管外科, 上海 200433
*通信作者)
摘要:
心力衰竭是一种复杂的病理生理综合征,平衡自主神经活性及抑制心肌重构是提高心力衰竭患者远期疗效的重要方法。尽管近些年在药物治疗方面取得了一些进展,如使用β-受体阻滞剂抑制交感神经激活对心脏的毒性作用已成为心力衰竭药物治疗的经典方案,但心力衰竭的发病率仍呈上升趋势,并且患者生存能力持续降低。近年来,针对抑制交感神经系统过度激活的外科治疗手段逐渐出现,包括迷走神经电刺激术、压力感受器刺激治疗等,部分治疗方法在动物实验和初步临床研究中观察到明显的获益结果,但在心力衰竭患者中的作用还需进一步的临床试验加以验证。
关键词:  心力衰竭  迷走神经刺激  肾交感神经去除术  心交感神经去除术
DOI:10.16781/j.0258-879x.2020.01.0069
投稿时间:2019-06-27修订日期:2019-09-17
基金项目:
Autonomic nervous intervention in treatment of heart failure: recent progress
GAO Yuan,HAN Lin*
(Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Heart failure is a complicated pathophysiological syndrome. Balancing autonomic nervous activity and inhibiting myocardial remodeling are important methods for improving long-term efficacy in patients with heart failure. Pharmacologic management has been greatly developed, for example, the use of β-blockers is intended to inhibit the toxic effect of sympathetic activation on the heart and has become a classic treatment for heart failure. However, the incidence of heart failure is still on the rise and survivability is persistently reduced. In recent years, surgical treatments for inhibiting excessive activation of the sympathetic nervous system have emerged, such as vagus nerve stimulation, baroreceptor activation therapy. Some methods have obtained significant benefits in animal experiments and preliminary clinical study. It is essential to further verify the role of the above treatments in patients with heart failure in clinical trials.
Key words:  heart failure  vagus nerve stimulation  renal sympathetic denervation  cardiac sympathetic denervation