摘要
先天性心脏病的代偿期与失代偿期存在着不同程度的交感神经系统的激活和神经内分泌系统的紊乱,以及纤溶系统功能失衡。因此多种缩血管物质如血管紧张素Ⅱ(Ang II)、内皮素-1(ET-1)、去甲肾上腺素(NA)等生成与释放增加,而舒血管物质如一氧化碳(NO)、利尿钠肽等生成或作用降低。这些缩血管物质不仅加剧血流动力学的紊乱,而且某些物质还可以直接作用于心脏,损伤心肌细胞,诱导心肌细胞肥大与凋亡,促使先天性心脏病(CHD)患者的病情加重;同时CHD患者存在血管内皮细胞和血小板的功能障碍及凝血、抗凝系统的异常,可导致血液处于血栓前状态。而介入治疗(CHD封堵术)后,心内左向右分流被完全阻断,因此,CHD患者的交感神经系统和神经内分泌系统,以及纤溶系统的功能逐渐恢复正常。
The different degree activation of sympathetic nervous system and disturbances of neuroendocrine system and fibrinolytic system present in compensatory stage and decompensatory stage of congenital heart disease （ CHD）. Formation and replease of the varied vasoconstrietive materials is increased, including angiotensin-Ⅱ , endothelin-Ⅰ , and noradrenaline, etc. Inversely, formation and action of the vasodilative materials is decreased, such as nitric oxide, and natriuretic peptide, etc. Not only the vasoconstrictive materials lead to exacerbation of hemodynamic disorder, but also some of them directly act on the heart, and injure cardiac muscle cells, induce hypertrophy and apeptosis of myocanlial cells, and then promote exacerbation of congenital heart disease. At the same time, functional disturbance of vascular endothelial cells and blood plague, and abnormality of the blood coagulation and anticoagulant mechanisms can cause the blood in status pre-thrombosis. The blood from left to right shunt in the heart is entirely blacked by interventional therapy, then the function of the sympathetic nervous system, neuroendocrine system and fibrinolytic system gradually recovery normal.
出处
《医学综述》
2006年第4期244-246,共3页
Medical Recapitulate
基金
广西科技攻关项目(桂科攻0472002-30)
关键词
介入治疗
先天性心脏病
肾素-血管紧张素系统
血浆内皮素
纤溶状态
Interventional thempy
Congestive heart failwre
Renin-angiotension system
Plasma endothelin
Fibrinolytie status
