重新认识心衰机制中的心脏舒张期耗能  

New Understanding of Diastolic Energy Consumption in the Heart Failure Mechanism

作　　者：赵驰[1] 

机构地区：[1]大连市第二人民医院,辽宁大连116021

出　　处：《医学与哲学（B）》2013年第5期73-76,共4页Medicine & Philosophy(B)

摘　　要：长期以来,对心衰和心衰机制的认识一直存在争议,所以心衰的治疗一直是国内外心血管领域中的一个挑战。为了澄清心衰机制的内涵,本文用弗兰克-斯塔灵定律以及能量守恒定律作为重建心脏理论以及心衰机制的依据,论证了心脏的做功是从动能向势能,又从势能向动能的转换过程。并根据临床事实等来证实心脏舒张是在作功,与收缩期作功是等同的。没有心脏的舒张就没有心脏的收缩,心脏功能下降实际上是舒张与收缩功能同时的下降。不存在有收缩功能正常的舒张功能下降。心功能的判定标准不能采用射血分数,而应该采取能量消耗的定量方法来测定。The treatment of heart failure has been a major clinical challenge, and the understanding of heart failure and its mechanism has provoked enormous debate and a wealth of mechanistic studies. In order to clarify the connotation of heart failure mechanism, the Frank --Staring law and the law of energy conservation were used as the theoretical basis of heart failure mechanism. The heart working is the process of energy conversion from pressure to volume and then from volume to pressure （i. e. , from kinetic energy to potential energy and then from potential energy to kinetic energy）. A new insight from basic and clinical evidences confirmed the fact of the diastolic is not a passive process. Both of the diastole and systole are active process and the amounts of the energy consumption are equal in both periods. For the heart, systole cannot exist unless there is a diastole, the decreasing cardiac function is actually due to a simultaneous decrease in the diastolic and sys- tolic functions. The left ventricular ejection fraction cannot be used to evaluate left ventricular systolic function. Cardiac function should be measured using the energy consumption determination method.

关 键 词：心衰机制 舒张期功能 能量守恒定律 弗兰克-斯塔灵定律 KILLIP分级 

分 类 号：R541.6[医药卫生—心血管疾病]