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由于扩血管药物治疗充血性心力衰竭(CHF)的可喜疗效,正性变力剂在治疗CHF中的地位受到了挑战,甚至声言将取代强心甙者。然多数学者认为:根据维持心泵功能的三项反射机制,正性变力剂仍是治疗CHF的主要药物之一。一、正性变力剂治疗CHF 的理论基础及其地位CHF 最终都表现为心室肌细胞收缩力不足。为使心排血量不至过分减少,心脏便动员其代偿机制:(1)Frank-Starling 内在反射机制。此代偿机制虽可使心肌收缩力增强,但因CHF 时心肌纤维伸长过度,心肌收缩力反而减弱。正性变力剂通过增加心肌的收缩力
Due to the pleasing efficacy of vasodilators in the treatment of congestive heart failure (CHF), the positive agents in the treatment of CHF have been challenged, and even claimed to replace cardiac glycosides. However, most scholars believe that according to the three reflection mechanisms that maintain cardiac pump function, positive varicosities are still one of the main drugs for the treatment of CHF. First, the positive agent for the treatment of CHF theoretical basis and its status CHF eventually showed lack of contractility of ventricular myocytes. In order to make the cardiac output is not reduced too much, the heart will mobilize its compensation mechanism: (1) Frank-Starling intrinsic reflection mechanism. Although this compensatory mechanism can enhance myocardial contractility, but myocardial fibrosis due to excessive CHF, myocardial contractility but weakened. Positive mutagen by increasing myocardial contractility