ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2023, Vol. 15 ›› Issue (6): 494-499.

• 综述 • 上一篇    下一篇

儿童心力衰竭的临床特点及治疗进展

  

  • 出版日期:2023-12-25 上线日期:2024-03-06

Progress in the clinical features and treatment of pediatric heart failure

  • Published:2023-12-25 Online:2024-03-06

摘要: 心力衰竭是由于心脏结构或功能异常导致心脏收缩和(或)充盈功能受限,心输出量不能满足机体需求而引起的临床综合征。心力衰竭是常见的儿童危重症之一,儿童由于各个器官尚未发育成熟,若心力衰竭不能纠正,各个器官更易发生损害导致并发症、后遗症,不仅严重危害儿童生命健康,且治疗困难、预后不佳,给家庭及社会带来沉重的医疗负担。儿童心力衰竭的病因、病理生理特点、治疗方案等与成人心力衰竭有很大不同。儿童心力衰竭的主要病因是先天性心血管发育异常,其他病因包括心肌炎、心肌病以及冠脉异常等。儿童与成人相比,肾上腺素受体表达水平、miRNA谱、心肌异常相关基因表达等方面都存在差异。儿童心力衰竭的治疗包括病因治疗、药物治疗、细胞治疗、辅助装置治疗。儿童心力衰竭的治疗与长期管理方案与成人相比更具挑战性。本文围绕儿童心力衰竭的流行病学、病因、病理生理特点、治疗等方面进行综述。

关键词: 心力衰竭, 临床特点, 治疗, 儿童

Abstract: Heart failure is a clinical syndrome caused by structural or functional abnormalities of the heart,which result in limited cardiac contraction and/or filling,and cardiac output cannot meet the body′s demand.Heart failure is one of the common critical diseases in children.Since all organs of children are not yet mature,if heart failure cannot be corrected,all organs are more likely to be damaged,leading to complications and sequelae,which not only seriously jeopardize children′s lives and health,but also bring heavy medical burden to families and society due to difficulty in treatment and poor prognosis.The etiology,pathophysiological characteristics,and treatments of heart failure in children are very different from those of adult heart failure.The main cause of heart failure in children is congenital cardiovascular abnormalities,while other causes include myocarditis,cardiomyopathy,and coronary artery abnormalities.Adrenergic receptor expression levels,miRNA profiles,and expression of genes associated with myocardial abnormalities differ between children and adults.The treatment for heart failure in children includes etiologic treatment,pharmacotherapy,cell-based therapy,and auxiliary device therapies.Treatment and long-term management regimens for heart failure in children are more challenging than those in adults.This article will review the epidemiology,etiology,pathophysiological features,and treatment of heart failure in children.

Key words:

Heart failure, Clinical features, Treatment, Children