\u5fc3\u529b\u8870\u7aed(heartfailure,HF)\u662f\u5404\u7c7b\u5fc3\u8840\u7ba1\u75be\u75c5\u53d1\u5c55\u7684\u7ec8\u672b\u9636\u6bb5\uff0c\u4e3b\u8981\u4e34\u5e8a\u8868\u73b0\u4e3a\u547c\u5438\u56f0\u96be\u3001\u4e4f\u529b\u548c\u6db2\u4f53\u6f74\u7559\uff0c\u8fd9\u79cd\u75be\u75c5\u597d\u53d1\u4e8e\u8001\u5e74\u4eba\u3002\u8fd1\u5e74\u6765\uff0c\u6211\u56fd\u6b63\u5904\u4e8e\u8001\u9f84\u5316\u793e\u4f1a\uff0c\u8001\u5e74\u4eba\u6210\u4e3a\u5fc3\u529b\u8870\u7aed\u7684\u4e3b\u8981\u53d1\u75c5\u4eba\u7fa4\uff0c\u5176\u53d1\u75c5\u7387\u3001\u75c5\u6b7b\u7387\u9ad8\uff0c\u5c3d\u7ba1\u6cbb\u7597\u5fc3\u529b\u8870\u7aed\u7684\u624b\u6bb5\u4e0d\u65ad\u5b8c\u5584\uff0c\u4f46\u5b83\u4ecd\u662f\u76ee\u524d\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u3002<\/p>\n
\u5bf9\u4e8e\u8001\u5e74\u4eba\u6765\u8bf4\uff0c\u7531\u4e8e\u81ea\u8eab\u673a\u4f53\u529f\u80fd\u7684\u8870\u9000\uff0c\u5f88\u5bb9\u6613\u53d1\u751f\u5fc3\u529f\u80fd\u4e0d\u5168\uff0c\u5bfc\u81f4\u5bb9\u91cf\u8d1f\u8377\u8fc7\u91cd\u3001\u5168\u8eab\u7ec4\u7ec7\u704c\u6ce8\u4e0d\u8db3\u7b49\uff0c\u800c\u5bb9\u91cf\u8d85\u8d1f\u8377\u548c\u80ba\u6de4\u8840\u75c7\u72b6\u662f\u8001\u5e74HF\u60a3\u8005\u4f4f\u9662\u7684\u4e3b\u8981\u539f\u56e0\uff0c\u5236\u5b9a\u5408\u7406\u7684\u5bb9\u91cf\u7ba1\u7406\u65b9\u6848\u5df2\u7ecf\u6210\u4e3a\u8001\u5e74HF\u6cbb\u7597\u7684\u5173\u952e\u4e00\u73af\u3002<\/p>\n
\u8001\u5e74HF\u60a3\u8005\u7684\u5bb9\u91cf\u7ba1\u7406\u662f\u6307\u4fdd\u8bc1\u5fc3\u8f93\u51fa\u91cf\u57fa\u7840\u4e0a\u83b7\u5f97\u6700\u4f4e\u80ba\u52a8\u8109\u6954\u538b\uff0c\u4fdd\u8bc1\u5bb9\u91cf\u5145\u8db3\u7684\u57fa\u7840\u4e0a\u5c3d\u91cf\u51cf\u8f7b\u5fc3\u810f\u524d\u8d1f\u8377\uff0c\u4f7f\u4e4b\u8fbe\u5230\u6db2\u4f53\u8d1f\u5e73\u8861\u72b6\u6001\uff0c\u4ee5\u6539\u5584\u60a3\u8005\u9884\u540e\u3001\u964d\u4f4e\u518d\u5165\u9662\u7387\u53ca\u63d0\u9ad8\u751f\u6d3b\u8d28\u91cf\u3002\u76f8\u5bf9\u4e8e\u5176\u4ed6HF\u60a3\u8005\u7684\u6cbb\u7597\u63aa\u65bd\uff0c\u5bf9\u8001\u5e74HF\u60a3\u8005\u7684\u5bb9\u91cf\u7ba1\u7406\u8981\u66f4\u4e3a\u91cd\u8981\u53ca\u4e25\u683c\uff0c\u5982\u4f55\u7b80\u5355\u6709\u6548\u8bc4\u4f30\u53ca\u5b9e\u65bd\u5bb9\u91cf\u7ba1\u7406\u5df2\u6210\u4e3a\u4e34\u5e8a\u4e3b\u8981\u5173\u6ce8\u70b9\u3002<\/p>\n
01\u5fc3\u529b\u8870\u7aed\u7684\u75c5\u56e0<\/p>\n
1. \u5fc3\u808c\u75c5\u53d8<\/p>\n
\u5305\u62ec\u539f\u53d1\u6027\u5fc3\u808c\u635f\u5bb3(\u8001\u5e74\u4eba\u5e38\u89c1\u7684\u5982\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u5bfc\u81f4\u7684\u7f3a\u8840\u6027\u5fc3\u808c\u635f\u5bb3\u7b49)\u548c\u7ee7\u53d1\u6027\u5fc3\u808c\u635f\u5bb3(\u8001\u5e74\u4eba\u5e38\u89c1\u7684\u5982\u7532\u72b6\u817a\u529f\u80fd\u4ea2\u8fdb\u6216\u529f\u80fd\u51cf\u9000\u3001\u7cd6\u5c3f\u75c5\u7b49\u5185\u5206\u6ccc\u4ee3\u8c22\u6027\u75be\u75c5\u3001\u7cfb\u7edf\u6027\u6d78\u6da6\u6027\u75be\u75c5\u548c\u5fc3\u810f\u6bd2\u6027\u836f\u7269\u7b49)\u3002<\/p>\n
2. \u5fc3\u810f\u8d1f\u8377\u8fc7\u5ea6<\/p>\n
\u540e\u8d1f\u8377\u8fc7\u5ea6\uff1a\u9ad8\u8840\u538b\u3001\u80ba\u52a8\u8109\u9ad8\u538b\u3001\u80ba\u6813\u585e\u53ca\u80ba\u963b\u585e\u6027\u75be\u75c5\u7b49\u3002<\/p>\n
\u524d\u8d1f\u8377\u8fc7\u5ea6\uff1a\u74e3\u819c\u5173\u95ed\u4e0d\u5168\u3001\u4e25\u91cd\u8d2b\u8840\u3001\u7532\u72b6\u817a\u529f\u80fd\u4ea2\u8fdb\u3001\u52a8\u9759\u8109\u7618\u3001\u811a\u6c14\u6027\u5fc3\u810f\u75c5\u7b49\u3002<\/p>\n<\/p>\n
02\u8001\u5e74\u60a3\u8005\u7684HF\u7279\u70b9<\/p>\n
1. \u8001\u5e74\u6162\u6027\u5fc3\u8870\u5e76\u53d1\u75c7\u591a\u3001\u6709\u8f83\u957f\u7684\u5fc3\u529f\u80fd\u4e0d\u5168\u53f2\uff0c\u4e14\u66f4\u6613\u53d1\u751f\u6162\u6027HF\u6025\u6027\u5931\u4ee3\u507f\u60c5\u51b5\u3002<\/p>\n
2. HF\u662f\u4e00\u79cd\u589e\u9f84\u6027\u5fc3\u810f\u75c5\uff0c\u5176\u75c5\u56e0\u660e\u786e\u3001\u7a0b\u5ea6\u91cd\u3001\u75c7\u72b6\u53ca\u4f53\u5f81\u4e0d\u5178\u578b\u3001\u591a\u4f34\u4e25\u91cd\u5e76\u53d1\u75c7\u3001\u9884\u540e\u5dee\u3001\u75c5\u6b7b\u7387\u53ca\u81f4\u6b8b\u7387\u8f83\u9ad8\u3002<\/p>\n
3. \u8001\u5e74\u4eba\u51fa\u9662\u540e\u5e38\u64c5\u81ea\u505c\u836f\u6216\u4e0d\u89c4\u5219\u670d\u836f\u800c\u8f6c\u4e3a\u96be\u6cbb\u6027\u5fc3\u8870\u3002\u8001\u5e74(>60\u5c81)HF\u60a3\u8005\u591a\u4e3a\u5c04\u8840\u5206\u6570\u4fdd\u7559\u7684\u5fc3\u529b\u8870\u7aed(HFpEF)\uff0c\u5176\u5de6\u5ba4\u5c04\u8840\u5206\u6570\u226550%\uff0c\u4e3b\u8981\u6cbb\u7597\u63aa\u65bd\u662f\u7f13\u89e3\u6c34\u94a0\u6f74\u7559\uff0c\u4f7f\u60a3\u8005\u4fdd\u6301\u5728\u7b49\u5bb9\u91cf\u6c34\u5e73\uff0c\u800c\u5728HF\u6025\u6027\u53d1\u4f5c\u65f6\u7ef4\u6301\u8d1f\u5e73\u8861\u3002<\/p>\n<\/p>\n
03\u6cbb\u7597\u539f\u5219<\/p>\n
\u8001\u5e74HF\u60a3\u8005\u5931\u4ee3\u507f\u65f6\u7684\u7acb\u5373\u76ee\u6807\u662f\u5224\u65ad\u53ca\u7ea0\u6b63\u8840\u6d41\u52a8\u529b\u5b66\u60c5\u51b5\uff0c\u5f3a\u8c03\u53ca\u65f6\u6cbb\u7597\u3002\u5bf9\u8001\u5e74HF\u60a3\u8005\u6cbb\u7597\u539f\u5219\u662f\u5145\u5206\u6e05\u9664\u673a\u4f53\u5185\u8fc7\u5269\u7684\u4f53\u6db2\uff0c\u540c\u65f6\u907f\u514d\u795e\u7ecf\u5185\u5206\u6ccc\u7cfb\u7edf\u8fc7\u5ea6\u6fc0\u6d3b\u3002\u4e34\u5e8a\u4e0a\u591a\u4ece\u51fa\u5165\u91cf\u7ba1\u7406\u3001\u836f\u7269\u6cbb\u7597\u53ca\u8840\u6db2\u8d85\u6ee4\u7b49\u65b9\u9762\u6765\u7a33\u5b9a\u5176\u8840\u6d41\u52a8\u529b\u5b66\uff0c\u4ece\u800c\u964d\u4f4e\u5fc3\u810f\u524d\u540e\u8d1f\u8377\u3002<\/p>\n
1. \u51fa\u5165\u91cf\u7ba1\u7406<\/p>\n
\u4e34\u5e8a\u4e0a\u591a\u91c7\u7528\u7efc\u5408\u8bc4\u4f30\u8bca\u65ad\u5bb9\u91cf\u8d85\u8d1f\u8377\uff0c\u5982\u6709\u65e0\u8fd1\u671f\u4f53\u91cd\u589e\u52a0\u3001\u5c3f\u5c11\u3001\u6c34\u80bf\u3001\u8111\u94a0\u80bd(brainnatriureticpeptide\uff0cBNP)\u5347\u9ad8\u7b49\u3002<\/p>\n
\u4f4f\u9662\u671f\u95f4\u5bf9\u8001\u5e74HF\u60a3\u8005\u6bcf\u5929\u5e94\u5b9e\u65f6\u8bb0\u5f55\u53ca\u52a8\u6001\u89c2\u5bdf\u4f53\u91cd\u3001\u8bb0\u5f5524\u5c0f\u65f6\u5c3f\u91cf\u3001\u8840\u538b\u3001\u6c34\u80bf\u53ca\u6c14\u4fc3\u60c5\u51b5\u3001\u80ba\u90e8\u5570\u97f3\u3001\u9888\u9759\u8109\u538b\u3001\u76ae\u80a4\u704c\u6ce8\u3001BNP\u3001\u8bb0\u5f55\u996e\u98df\uff0c\u8fd8\u53ef\u6d4b\u4e2d\u5fc3\u9759\u8109\u538b(CVP)\u3001\u80ba\u6bdb\u7ec6\u8840\u7ba1\u6954\u538b(PCWP)\u3001\u8109\u640f\u7b49\uff0c\u4e25\u683c\u6307\u5bfc\u51fa\u5165\u91cf\u7ba1\u7406\u3002<\/p>\n
\u5404\u6307\u6807\u610f\u4e49\u5982\u4e0b:<\/p>\n
(1) \u636e\u4f53\u91cd\u53d8\u5316\u8c03\u6574\u51fa\u5165\u91cf\uff1a\u5982\u4f53\u91cd3\u5929\u5185\u7a81\u7136\u589e\u52a0\u5927\u4e8e2kg\u5219\u987b\u589e\u52a0\u51fa\u91cf\u53ca\u9650\u5236\u5165\u91cf\u3002<\/p>\n
(2) 24\u5c0f\u65f6\u5c3f\u91cf\uff1a\u6ce8\u610f\u6709\u65e0\u77ed\u671f\u5185\u5c3f\u91cf\u51cf\u5c11\uff0c\u5165\u91cf\u5927\u4e8e\u51fa\u91cf\u7684\u60c5\u51b5\uff0c\u8001\u5e74\u6162\u6027HF\u60a3\u8005\u5e94\u4fdd\u6301\u5c3f\u91cf\u7ea62L\/d\uff0c\u8001\u5e74\u6025\u6027HF\u4fdd\u6301\u5c3f\u91cf\u7ea63~5L\/d\u3002<\/p>\n
(3) \u8840\u538b\uff1a\u53cd\u6620\u60a3\u8005\u7684\u5bb9\u91cf\u72b6\u51b5\uff0c\u9274\u522b\u5bb9\u91cf\u5145\u8db3\u4e0e\u5426\uff0c\u5982\u5229\u5c3f\u5242\u6709\u65e0\u8fc7\u5ea6\u4f7f\u7528\u3001\u51fa\u5165\u91cf\u6709\u65e0\u51fa\u8d85\u3001\u76ae\u80a4\u6709\u65e0\u5e72\u71e5\u3001\u6709\u65e0\u53e3\u5e72\u7b49\u3002\u5f53\u8840\u538b\u5347\u9ad8\u65f6\u63a7\u5236\u5165\u91cf\u548c\u589e\u52a0\u51fa\u91cf\u540e\u8840\u538b\u964d\u4f4e\u63d0\u793a\u5bb9\u91cf\u8d85\u8d1f\u8377\u30022017ACC\/AHA\/HFSA\u5fc3\u529b\u8870\u7aed\u7ba1\u7406\u6307\u5357\u6307\u51fa\u5bf9\u4e8eHFpEF\u548c\u6301\u7eed\u6027\u9ad8\u8840\u538b\u7684\u8001\u5e74\u60a3\u8005\u6536\u7f29\u538b\u76ee\u6807\u503c\u5e94\u63a7\u5236\u5728130mmHg\u4ee5\u4e0b\u3002<\/p>\n
(4) \u6c34\u80bf\uff1a\u8bc4\u4f30\u5bb9\u91cf\u8d85\u8d1f\u8377\u7a0b\u5ea6\u3002<\/p>\n
(5) \u8840BNP\uff1a\u53cd\u6620\u673a\u4f53\u5bb9\u91cf\u8d1f\u8377\u72b6\u6001\u3002<\/p>\n
CVP>12cmH2O\u3001PCWP>16cmH2O\u63d0\u793a\u5bb9\u91cf\u8d85\u8d1f\u8377\uff0c\u5e76\u4e14\u80fd\u66f4\u51c6\u786e\u53cd\u6620\u673a\u4f53\u5bb9\u91cf\u72b6\u6001\u3002\u4e34\u5e8a\u4e0a\u5e38\u6839\u636e\u4ee5\u4e0a\u591a\u79cd\u6307\u6807\u6307\u5bfc\u8865\u6db2\u53ca\u5229\u5c3f\uff0c\u6539\u5584HF\u75c7\u72b6\u53ca\u4f53\u5f81\u3002<\/p>\n<\/p>\n
2. \u63a7\u5236\u6db2\u4f53\u6444\u5165<\/p>\n
\u9650\u5236\u6db2\u4f53\u5165\u91cf\u4e3a\u9884\u9632\u5bb9\u91cf\u8d1f\u8377\u8fc7\u91cd\u7684\u57fa\u7840\u3002\u6db2\u4f53\u51fa\u5165\u91cf\u8981\u4ee5\u7ef4\u6301\u4f53\u91cd\u3001\u6c34\u80bf\u75c7\u72b6\u51cf\u8f7b\u7b49\u4e3a\u57fa\u7840\u3002\u5bf9\u8001\u5e74\u4eba\u5e94\u5c3d\u91cf\u5c11\u8f93\u6216\u4e0d\u8f93\u6c2f\u5316\u94a0\u6eb6\u6db2\uff0c\u4ee5\u514d\u6c34\u94a0\u6f74\u7559\uff0c\u52a0\u91cdHF\u75c7\u72b6\u3002<\/p>\n
(1) \u5bf9\u4f34\u6709\u4f53\u6db2\u6f74\u7559\u8005\u5e94\u4e25\u683c\u9650\u5236\u996e\u6c34\u91cf\u548c\u8865\u6db2\u901f\u5ea6\uff0c\u9650\u5236\u94a0\u6444\u5165<2g\/d\u3002<\/p>\n
(2) \u4e25\u91cd\u80ba\u6c34\u80bf\u8005\uff0c\u51fa\u5165\u91cf\u8d1f\u5e73\u8861\u53ef1~2L\/d\uff0c\u751a\u81f3\u53ef\u8fbe3~5L\/d\uff0c3~5\u5929\u540e\uff0c\u82e5BNP\u3001\u6db2\u4f53\u6f74\u7559\u75c7\u72b6\u660e\u663e\u597d\u8f6c\u5e94\u51cf\u5c11\u6c34\u8d1f\u5e73\u8861\uff0c\u9010\u6b65\u8fc7\u5ea6\u5230\u51fa\u5165\u91cf\u5927\u81f4\u6301\u5e73\uff0c\u540c\u65f6\u9650\u5236\u94a0\u6444\u5165\u5c0f\u4e8e2g\/d\u3002(3)\u672a\u51fa\u73b0\u660e\u663e\u4f4e\u8840\u5bb9\u91cf\u8005\uff0c\u6db2\u4f53\u5165\u91cf\u6bcf\u5929\u8981\u5c11\u4e8e1.5L\uff0c\u4e0d\u591a\u4e8e2L\u3002<\/p>\n
(4) \u8840\u94a0<130mmol\/L\u65f6\u6bcf\u5929\u6db2\u4f53\u6444\u5165\u91cf\u5e94<2L\u3002<\/p>\n
(5) \u4e25\u91cdHF\u60a3\u8005\u6bcf\u5929\u6db2\u4f53\u6444\u5165\u5e94\u5c0f\u4e8e1.5~2.0L\uff0c\u8f7b\u4e2d\u5ea6HF\u60a3\u8005\u5e38\u89c4\u65e0\u9700\u9650\u6db2\u3002<\/p>\n
(6) \u7f8e\u56fd\u7ebd\u7ea6\u5fc3\u810f\u75c5\u534f\u4f1a(NYHA)\u2162~\u2163\u7ea7\u8001\u5e74HF\u60a3\u8005\u8981\u9650\u5236\u94a0\u6444\u5165<3g\/d\uff0c\u4f7f\u7528\u5229\u5c3f\u5242\u8005\uff0c\u53ef\u653e\u5bbd\u3002\u4e34\u5e8a\u4e0a\u8981\u6839\u636e\u5b9e\u9645\u51fa\u5165\u91cf\u3001\u4f53\u91cd\u53d8\u5316\u53ca\u4e34\u5e8a\u8868\u73b0\u7b49\u60c5\u51b5\u5b9e\u884c\u4e2a\u4f53\u5316\u65b9\u6848\u3002<\/p>\n
3. \u5229\u5c3f\u5242<\/p>\n
\u5229\u5c3f\u5242\u662f\u80fd\u51cf\u5c11HF\u60a3\u8005\u6c34\u94a0\u6f74\u7559\u7684\u836f\u7269\uff0c\u8001\u5e74\u6162\u6027HF\u60a3\u8005\u82e5\u5b58\u5728\u6db2\u4f53\u6f74\u7559\u6216\u8001\u5e74\u6025\u6027HF\u53d1\u4f5c\u65f6\uff0c\u63a8\u8350\u4f7f\u7528\u5229\u5c3f\u5242\u3002\u8001\u5e74\u4eba\u5bf9\u4f53\u6db2\u6025\u5267\u53d8\u5316\u7684\u4ee3\u507f\u548c\u9002\u5e94\u80fd\u529b\u8f83\u5dee\uff0c\u5927\u91cf\u5229\u5c3f\u5242\u4f7f\u7528\u540e\u6613\u5bfc\u81f4\u4f53\u4f4d\u6027\u4f4e\u8840\u538b\uff0c\u6545\u8001\u5e74\u4eba\u7528\u836f\u5e94\u51cf\u5c11\u521d\u59cb\u5242\u91cf\uff0c\u5e76\u6839\u636e\u60a3\u8005\u51fa\u5165\u91cf\u3001\u4f53\u91cd\u53d8\u5316\u60c5\u51b5\u7f13\u6162\u7684\u589e\u52a0\u5242\u91cf\u3002<\/p>\n
\u8001\u5e74\u6162\u6027HF\u60a3\u8005\u5e94\u9009\u62e9\u4e2d\u7b49\u5f3a\u5ea6\u7684\u5229\u5c3f\u5242(\u6c22\u6c2f\u567b\u55ea\u3001\u6c28\u82ef\u8776\u5576\u3001\u87ba\u5185\u916f)\uff0c\u5c0f\u5242\u91cf\u3001\u7f13\u6162\u95f4\u65ad\u7ed9\u836f\uff0c\u800c\u6025\u6027\u5de6\u5fc3\u529b\u8870\u7aed\u53ca\u6709\u660e\u663e\u6c34\u94a0\u6f74\u7559\u8005\u6216\u4e25\u91cdHF\u65f6\u5e94\u4e34\u65f6\u4f7f\u7528\u88a2\u5229\u5c3f\u5242\u4ee5\u51cf\u8f7b\u5fc3\u810f\u524d\u8d1f\u8377\u3002\u5229\u5c3f\u5242\u5305\u62ec\u88a2\u5229\u5c3f\u5242\u3001\u567b\u55ea\u7c7b\u5229\u5c3f\u5242\u3001\u919b\u56fa\u916e\u53d7\u4f53\u62ee\u6297\u5242\u3001\u4fdd\u94be\u6027\u5229\u5c3f\u5242\u3002<\/p>\n
4. \u8840\u7ba1\u6269\u5f20\u5242<\/p>\n
\u8840\u7ba1\u6269\u5f20\u5242\u53ef\u51cf\u8f7b\u5fc3\u810f\u8d1f\u8377\u3002\u9ad8\u9f84\u60a3\u8005\u4f7f\u7528\u65f6\u6613\u5f15\u8d77\u4f4e\u8840\u538b\uff0c\u4f5c\u4e3a\u521d\u59cb\u6cbb\u7597\u65f6\u8981\u4ece\u5c0f\u5242\u91cf\u5f00\u59cb\uff0c\u9010\u6e10\u52a0\u91cf\uff0c\u5e76\u6839\u636e\u8840\u538b\u60c5\u51b5\u968f\u65f6\u8c03\u6574\u7528\u91cf\u3002\u5305\u62ec\u91cd\u7ec4\u4eba\u8111\u5229\u94a0\u80bd\u3001\u785d\u9178\u916f\u7c7b\u548c\u785d\u666e\u94a0\u7b49\u3002<\/p>\n
\u785d\u9178\u916f\u7c7b\u836f\u7269\u9759\u8109\u6cf5\u5165\u8d77\u59cb\u5242\u91cf\u4e3a5~10\u03bcg\/min\uff0c\u6700\u5927\u5242\u91cf200\u03bcg\/min;\u785d\u666e\u94a0\u9002\u7528\u4e8e\u540e\u8d1f\u8377\u589e\u52a0\u3001\u4e25\u91cdHF\u4ee5\u53ca\u80ba\u6de4\u8840\u6216\u80ba\u6c34\u80bf\u60a3\u8005\uff0c\u9759\u8109\u6cf5\u5165\u8d77\u59cb\u5242\u91cf\u4e3a0.3\u03bcg\/(kg\u00b7min)\uff0c\u6700\u5927\u5242\u91cf\u53ef\u8fbe10\u03bcg\/(kg\u00b7min)\u3002<\/p>\n
\u91cd\u7ec4\u4eba\u8111\u5229\u94a0\u80bd(\u8418\u897f\u7acb\u80bd)\u80fd\u591f\u5feb\u901f\u6539\u5584\u6025\u6027\u5931\u4ee3\u507f\u6027HF\u60a3\u8005\u8840\u6d41\u52a8\u529b\u5b66\u53caPCWP\uff0c\u6cbb\u7597\u6548\u679c\u6bd4\u785d\u9178\u916f\u7c7b\u836f\u7269\u597d\u3002\u4e14\u5bf9\u8840\u538b\u3001\u5fc3\u7387\u53ca\u5fc3\u5f8b\u5f71\u54cd\u5c0f\uff0c\u6ca1\u6709\u53d1\u73b0\u75c7\u72b6\u6027\u4f4e\u8840\u538b\u53ca\u5176\u4ed6\u7684\u4e25\u91cd\u4e0d\u826f\u53cd\u5e94\u3002\u5f53\u6536\u7f29\u538b\u2265100mmHg\u4e14\u4e0a\u8ff0\u5229\u5c3f\u5242\u6548\u679c\u4e0d\u4f73\u65f6\u53ef\u52a0\u7528\u91cd\u7ec4\u4eba\u8111\u5229\u94a0\u80bd\u3002<\/p>\n
5. \u8840\u7ba1\u7d27\u5f20\u7d20\u8f6c\u5316\u9176\u6291\u5236\u5242\u7c7b\u836f\u7269<\/p>\n
ACEI\u7c7b\u836f\u7269\u662f\u6539\u5584\u8001\u5e74\u6162\u6027HF\u60a3\u8005\u75c7\u72b6\u53ca\u9884\u540e\u7684\u91cd\u8981\u836f\u7269\uff0c\u53ef\u964d\u4f4e\u5fc3\u810f\u524d\u540e\u8d1f\u8377\uff0c\u5e76\u4e0e\u5229\u5c3f\u5242\u534f\u540c\u53d1\u6325\u4f5c\u7528\u3002\u9002\u7528\u4e8e\u8001\u5e74\u987d\u56fa\u6027\u6162\u6027HF\u6216\u4f34\u9ad8\u8840\u538b\u8005\uff0c\u5bf9\u5229\u5c3f\u5242\u3001\u8840\u7ba1\u6269\u5f20\u5242\u65e0\u6548\u7684\u8001\u5e74\u6162\u6027HF\u60a3\u8005\uff0c\u5e94\u5c3d\u65e9\u4ece\u5c0f\u5242\u91cf\u5f00\u59cb\u4f7f\u7528\uff0c\u4e00\u822c\u6bcf\u9694\u4e24\u5468\u589e\u52a0\u4e00\u500d\uff0c\u76f4\u81f3\u8fbe\u76ee\u6807\u5242\u91cf\uff0c\u8c03\u6574\u5230\u5408\u9002\u5242\u91cf\u540e\u7ec8\u8eab\u7ef4\u6301\u7528\u836f\u3002<\/p>\n
\u6700\u65b02017ACC\/AHA\/HFSA\u5fc3\u529b\u8870\u7aed\u7ba1\u7406\u6307\u5357\u63d0\u51fa\u5bf9\u4e8eHFpEF\u60a3\u8005\uff0c\u8840\u7ba1\u7d27\u5f20\u7d20\u53d7\u4f53\u548c\u8111\u5561\u80bd\u9176\u53cc\u91cd\u6291\u5236\u5242(ARNI)\u5bf9\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\u7684\u4fdd\u62a4\u4f5c\u7528\u4f18\u4e8eACEI\u6216ARB\uff0c\u5e76\u4e14\u53ef\u51cf\u5c11HFREF\u60a3\u8005\u7684\u6b7b\u4ea1\u548c\u518d\u5165\u9662\u7387\u3002\u56e0\u6b64ARNI\u7c7b\u836f\u7269\u662f\u8001\u5e74HF\u60a3\u8005\u6cbb\u7597\u7684\u798f\u97f3\u3002<\/p>\n
6. \u8840\u6db2\u8d85\u6ee4<\/p>\n
\u8840\u6db2\u8d85\u6ee4\u5bf9\u51cf\u8f7b\u5bb9\u91cf\u8d1f\u8377\u6709\u72ec\u7279\u4f18\u52bf\uff0c\u5b83\u53ef\u5b89\u5168\u6709\u6548\u5730\u6e05\u9664\u8001\u5e74HF\u60a3\u8005\u4f53\u5185\u591a\u4f59\u6db2\u4f53\uff0c\u6392\u51fa\u66f4\u591a\u94a0\uff0c\u4e14\u4e0d\u5f15\u8d77\u7535\u89e3\u8d28\u7d0a\u4e71\uff0c\u4e0d\u6fc0\u6d3b\u795e\u7ecf\u5185\u5206\u6ccc\u7cfb\u7edf\uff0c\u5e76\u5bf9\u90e8\u5206\u5229\u5c3f\u5242\u62b5\u6297\u60a3\u8005\u6709\u5f88\u597d\u7684\u6548\u679c\uff0c\u662f\u5feb\u901f\u51cf\u8f7bHF\u60a3\u8005\u5bb9\u91cf\u8d85\u8d1f\u8377\u7684\u4e00\u79cd\u53ef\u9009\u62e9\u65b9\u6cd5\u3002\u8d85\u6ee4\u6cbb\u7597\u671f\u95f4\u4e0d\u63a8\u8350\u540c\u65f6\u4f7f\u7528\u88a2\u5229\u5c3f\u5242\uff0c\u7ed3\u675f\u540e\u53ef\u6839\u636e\u5b9e\u9645\u72b6\u51b5\u9009\u62e9\u5229\u5c3f\u5242\u3002\u8fde\u7eed\u4f7f\u7528\u8d85\u6ee4\u65f6\u5e94\u907f\u514d\u51fa\u73b0\u5185\u73af\u5883\u7684\u7d0a\u4e71\uff0c\u5e76\u6ce8\u610f\u70ed\u91cf\u53ca\u86cb\u767d\u7684\u4e22\u5931\u3002<\/p>\n<\/p>\n
\u5c0f\u7ed3<\/p>\n
\u7efc\u4e0a\u6240\u8ff0\uff0c\u5728\u4e34\u5e8a\u5b9e\u9645\u5de5\u4f5c\u4e2d\uff0c\u8001\u5e74HF\u60a3\u8005\u6cbb\u7597\u6210\u529f\u7684\u5173\u952e\u662f\u5b9e\u73b0\u5bb9\u91cf\u76ee\u6807\u7ba1\u7406\u3002\u5bf9\u8001\u5e74HF\u60a3\u8005\u7684\u5bb9\u91cf\u8fdb\u884c\u89c4\u8303\u7ba1\u7406\uff0c\u5e76\u6784\u5efa\u89c4\u8303\u7684\u8bc4\u4f30\u6d41\u7a0b\uff0c\u638c\u63e1\u5bfc\u81f4\u5bb9\u91cf\u8d1f\u8377\u8fc7\u91cd\u7684\u673a\u5236\uff0c\u5e94\u7528\u5404\u79cd\u6cbb\u7597\u63aa\u65bd(\u51fa\u5165\u91cf\u7ba1\u7406\u3001\u5229\u5c3f\u3001\u836f\u7269\u6cbb\u7597\u53ca\u8840\u6db2\u8d85\u6ee4)\u4fdd\u8bc1\u5bb9\u91cf\u5e73\u8861\u662f\u8001\u5e74HF\u60a3\u8005\u5bb9\u91cf\u7ba1\u7406\u7684\u76ee\u6807\u3002\u4e3a\u4e86\u5b9e\u73b0\u8fd9\u4e00\u76ee\u6807\uff0c\u4ecd\u9700\u4e0d\u65ad\u8ba4\u8bc6\u53ca\u52a0\u5f3a\u5bf9\u8001\u5e74HF\u60a3\u8005\u6db2\u4f53\u7684\u7ba1\u7406\u53ca\u6539\u5584\u9884\u540e\u7b49\u7efc\u5408\u6cbb\u7597\u3002<\/p>\n
\u53c2\u8003\u6587\u732e\uff1a<\/p>\n
[1]\u6768\u4e1c\u6167,\u4f59\u60e0\u73cd.\u8001\u5e74\u5fc3\u529b\u8870\u7aed\u60a3\u8005\u7684\u5bb9\u91cf\u7ba1\u7406[J].\u521b\u4f24\u4e0e\u6025\u8bca\u7535\u5b50\u6742\u5fd7,2017,5(04):212-215.<\/p>\n
[2] \u5f20\u79c0\u9526,\u5218\u5b8f\u658c.\u8001\u5e74\u4eba\u5fc3\u529b\u8870\u7aed\u7684\u5bb9\u91cf\u7ba1\u7406\u8981\u70b9[J].\u4e2d\u534e\u8001\u5e74\u5fc3\u8111\u8840\u7ba1\u75c5\u6742\u5fd7,2022,24(06):659-661.<\/p>\n
[3] McDonagh TA,Metra M,Adamo M,et al.2021ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J].Eur Heart J,2021,42(36):3599-3726\uff0e<\/p>\n
[4] \u674e\u8273\u541b. \u8001\u5e74\u5fc3\u8870\u60a3\u8005\u7684\u4e2a\u4f53\u5316\u5bb9\u91cf\u7ba1\u7406\u6548\u679c\u7814\u7a76[D].\u897f\u5b89\u533b\u5b66\u9662,2020.<\/p>\n<\/p>\n
#artContent h1#artContent p img#artContent table<\/p>\n","protected":false},"excerpt":{"rendered":"
\u5fc3\u529b\u8870\u7aed(heartfailure,HF)\u662f\u5404\u7c7b\u5fc3\u8840\u7ba1\u75be\u75c5\u53d1\u5c55\u7684\u7ec8\u672b\u9636\u6bb5\uff0c\u4e3b\u8981\u4e34 … \u7ee7\u7eed\u9605\u8bfb