Drugs for the Treatment of Congestive Heart Failure ( CHF) 浙江大学医学院药理学系 张世红 shzhang713@zju.edu.cn
Drugs for the Treatment of Congestive Heart Failure （CHF） 1 浙江大学医学院药理学系 张世红 shzhang713@zju.edu.cn
Outlines ◆CHF概述 ◆CHF的治疗策略 ◆治疗cHF的药物
Outlines CHF概述 CHF的治疗策略 治疗CHF的药物 2
概述-CHF的定义和症状 ●充血性心力衰竭是指在静脉回流正常的情况下,由于原发的 心脏损害引起心排血量减少,不能满足组织代谢需要的一种 综合征。导致心衰的疾病包括冠心病,缺血性心脏病,心肌 病,高血压,心瓣膜病,肾病等。 ●临床上以肺循环和(体循环淤血以及组织血液灌注不足为 主要特征,包括无力、水肿、咳嗽、喘呜,咯血,头晕,心 律失常等
3 概述-CHF的定义和症状 ⚫充血性心力衰竭是指在静脉回流正常的情况下，由于原发的 心脏损害引起心排血量减少，不能满足组织代谢需要的一种 综合征。导致心衰的疾病包括冠心病，缺血性心脏病，心肌 病，高血压，心瓣膜病，肾病等。 ⚫临床上以肺循环和(或)体循环淤血以及组织血液灌注不足为 主要特征，包括无力、水肿、咳嗽、喘鸣，咯血，头晕，心 律失常等
概述-心力衰竭的类型 (1)收缩功能衰竭 the mechanical pumping action (contractility) and the ejection fraction of the heart are reduce d (2)舒张功能衰竭: stiffening and loss of adequate relaxation plays a major role in reducing cardiac output and ejection fraction may be normal. e. g Pericarditis(心包炎) (3)高输出型衰竭 can resu t from hyperthyroidism(甲亢 beriberi(脚气病), anemIa(贫血, and arteriovenous shunts(动静脉分流)
(1) 收缩功能衰竭: the mechanical pumping action (contractility) and the ejection fraction of the heart are reduced. (2) 舒张功能衰竭: stiffening and loss of adequate relaxation plays a major role in reducing cardiac output and ejection fraction may be normal. e.g. Pericarditis (心包炎) (3) 高输出型衰竭: can result from hyperthyroidism (甲亢), beriberi (脚气病), anemia (贫血), and arteriovenous shunts (动静脉分流). 概述-心力衰竭的类型 4
概述-心功能分级 根据症状对心功能分级: Class l: no limitation is experienced in any activities; no symptoms from ordinary activities Class l: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion Class l: marked limitation of any activity; the patient is comfortable only at rest Class IV: any physical activity brings on discomfort and symptoms occur at rest
概述-心功能分级 根据症状对心功能分级: Class I: no limitation is experienced in any activities; no symptoms from ordinary activities. Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion. Class III: marked limitation of any activity; the patient is comfortable only at rest. Class IV: any physical activity brings on discomfort and symptoms occur at rest. 5