晚期心力衰竭管理策略的研究进展  

Research progress on management strategies of advanced heart failure

作　　者：张吉 肖建强[1] 王屹丰 Zhang Ji;Xiao Jianqiang;Wang Yifeng(Department of Cardiology,Wujin Hospital Affiliated with Jiangsu University,the Wujin Clinical College of Xuzhou Medical University,Changzhou 213002,China;Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]江苏大学附属武进医院心内科、徐州医科大学武进临床学院,常州213002 [2]南京医科大学第一附属医院心内科、江苏省人民医院,南京210029

出　　处：《中华老年医学杂志》2024年第12期1651-1656,共6页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(82103925)。

摘　　要：晚期心力衰竭(心衰)即心力衰竭D阶段,是一种需要专门干预的资源密集型疾病状态,其临床过程高度可变,多种因素使其管理更加复杂。不断涌现的新药物、外科技术和器械治疗的进步延长了心衰患者的寿命。随着人口老龄化,晚期心衰患病率显著增加。晚期心衰通常与低心排血量综合征有关,其特点是越来越无法满足终末器官和骨骼肌代谢的需求。对于经指南指导的治疗后仍有心衰症状的患者来说,考虑心脏移植、长期机械循环辅助装置植入和姑息治疗是合适的。本文就晚期心衰的定义、关键特征、短期管理策略、长期管理策略和姑息治疗等方面进行综述。Advanced heart failure,also known as stage D heart failure,is a complex condition that requires specialized interventions due to its resource-intensive nature.The clinical course of advanced heart failure is highly unpredictable,with various factors complicating its management.The continuous development of new drugs,enhanced surgical techniques,and device therapy has the potential to extend the life expectancy of heart failure patients.With the aging population,the prevalence of advanced heart failure is on the rise.One of the defining characteristics of advanced heart failure is the inability to adequately meet the metabolic demands of end-organs and skeletal muscle,often associated with low cardiac output syndrome.For patients who do not respond to optimized guideline-directed therapies,consideration of heart transplantation,mechanical circulatory support,and palliative care is appropriate.This systematic review examines the definition,key features,short-term and long-term management strategies,as well as palliative care for advanced heart failure.

关 键 词：心力衰竭 心排血量 低 心脏移植 姑息性治疗 

分 类 号：R541.6[医药卫生—心血管疾病]