慢性心力衰竭神经调节治疗技术的应用与研究进展  

Application and research progress of neuromodulation therapy for chronic heart failure

作　　者：郭炳辰 唐昊 李光辉 段宇辰 涂应锋 GUO Bing-chen;TANG Hao;LI Guang-hui;DUAN Yu-chen;TU Ying-feng(Department of Cardiology,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,黑龙江哈尔滨150001

出　　处：《中国介入心脏病学杂志》2023年第8期603-608,共6页Chinese Journal of Interventional Cardiology

摘　　要：心力衰竭是大多数心血管疾病的终末期表现,在全球范围内,心力衰竭的负担已增加到约6400多万人。这些心力衰竭患者在基础药物治疗之后逐步改善预后和生活质量,但由于心力衰竭的复杂性和多样性,与多种危险因素、症状和并发症相关,以及尚未完全了解的病理生理机制,心力衰竭仍具有很高的发病率、住院率和死亡率。近几年来,慢性心力衰竭神经调节治疗技术取得了重大突破,用于治疗自主神经调节功能紊乱和心电活动异常的各种治疗技术正在慢性心力衰竭患者中进行研究。神经调节治疗技术主要用于改善机械不同步和自主神经失衡的电刺激和神经调节两个方面,这些技术包括经导管去肾交感神经术、内脏大神经消融术、迷走神经刺激术、肺动脉去神经术和心脏收缩调节器。本文旨在讨论目前慢性心力衰竭神经调节治疗技术的应用与研究进展。Heart f ailure is the end-stage manif estation of most cardiovascular diseases.Globally,the burden of heart f ailure has increased to approximately 64 million people.Although basic drug treatment has shown gradual improvement in the prognosis and quality of lif e of heart f ailure patients,the complexity and diversity of heart failure,along with its multiple risk factors,symptoms,complications,and incompletely understood pathophysiological mechanisms,contribute to its high morbidity,hospitalization rates,and mortality.In recent years,there have been signif icant advancements in neuromodulation therapy for chronic heart failure.Various therapeutic techniques for the treatment of autonomic neuromodulatory dysfunction and abnormal cardiac electrical activity are being studied in these patients with chronic heart failure.Neuromodulation therapy is mainly used These techniques include renal denervation,ablation of the greater splanchnic nerve,vagus nerve stimulation,pulmonary artery denervation,and cardiac contractility modulation.Both electrical stimulation and neuromodulation are utilized to improve mechanical dyssynchrony and autonomic imbalance.In this review,we discuss the current application and research progress of neuromodulation therapy for chronic heart failure.

关 键 词：心力衰竭 神经调节治疗 经导管去肾交感神经术 内脏大神经消融术 迷走神经刺激术 肺动脉去神经术 心脏收缩调节器 

分 类 号：R541[医药卫生—心血管疾病]