保留射血分数的心力衰竭病理生理机制和治疗的研究进展

doi:10.13481/j.1671-587x.20190244

摘要/Abstract

摘要： 保留射血分数的心力衰竭（HFpEF）在心力衰竭患者中占有极大的比例，其是指由于各种原因导致舒张功能下降引起的心力衰竭，而心肌收缩功能往往处于正常水平，通常伴有高血压、糖尿病、房颤和肾功能不全等各种并发症，这些并发症可促进疾病的进一步恶化，使住院的风险增加。HFpEF诊断的确切客观证据需要通过心导管检查获得，但是其属于有创检查，难以在临床上普遍展开，由于非侵入性辅助检查诊断的局限性，故目前尚无统一的临床标准。心肌细胞肥大及各种并发症可引起早期主动舒张能力减弱，而心室肌顺应性下降和僵硬度增加可引起晚期被动舒张能力减弱。传统的治疗药物虽然降低了射血分数（EF）减少的心力衰竭（HFrEF）患者的死亡率和再住院率，却不能显著改善HFpEF患者的预后，故HFpEF研究是目前临床研究的热点。本文对近些年公布的相关指南和发表的相关文献进行总结，阐述HFpEF的诊断、病理生理机制、辅助检查和并发症，总结传统的治疗药物和新型药物，提出治疗的新方向。

关键词: 心力衰竭, 保留射血分数, 病理生理机制, 心导管检查

中图分类号:

R541.6

邢寻静, 宋子凯, 唐明龙, 杨硕, 秦玲. 保留射血分数的心力衰竭病理生理机制和治疗的研究进展[J]. 吉林大学学报(医学版), 2019, 45(02): 457-464.

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