| 赵斐,林嘉婷,黄镇河.老年人心力衰竭与衰弱综合征的研究进展[J].中国临床保健杂志,2025,28(4):445-449. |
| 老年人心力衰竭与衰弱综合征的研究进展 |
| Research progress on heart failure and frailty syndrome in elderly people |
| 投稿时间：2025-06-16 |
| DOI：10.3969/J.issn.1672-6790.2025.04.003 |
| 中文关键词: 心力衰竭 衰弱 老年人 综述 |
| 英文关键词: Heart failure Frailty Aged Review |
| 基金项目:广东深圳市“医疗卫生三名工程”资助项目(SZSM202103011) |
|
| 摘要点击次数: 8 |
| 全文下载次数: 6 |
| 中文摘要: |
| 老年人心力衰竭与衰弱综合征常共存并形成恶性循环,显著增加不良预后风险。两者共同发病机制涉及慢性炎症通路(肿瘤坏死因子-α和白细胞介素-6介导肌肉降解与心肌纤维化)、神经内分泌失调(肾素-血管紧张素-醛固酮系统/交感神经系统 过度激活加剧能量失衡)及线粒体功能障碍(腺嘌呤核苷三磷酸生成减少加速细胞衰老)。两者交互作用显著:心力衰竭患者活动受限、营养恶化及多重用药加速衰弱进展；衰弱则降低患者治疗耐受性、增加再住院率。对同时有此2种疾病的患者进行临床干预需整合多领域策略:针对衰弱采用运动处方和营养优化；心力衰竭治疗需个体化药物调整并谨慎选择器械治疗；多学科团队协同干预,提高生活质量目标及远程监测,可降低再住院率。本文旨在系统阐述衰弱与老年人心力衰竭的交互机制及临床管理策略。 |
| 英文摘要: |
| Heart failure (HF) and frailty syndrome frequently coexist in the elderly,forming a vicious cycle that elevates risks of adverse outcomes.Shared mechanisms include chronic inflammation (TNF-α/IL-6-mediated muscle degradation and myocardial fibrosis),neuroendocrine dysregulation (RAAS/SNS overactivation exacerbating energy imbalance),and mitochondrial dysfunction (reduced ATP generation accelerating cellular aging).HF accelerates frailty via activity limitation,nutritional decline,and polypharmacy;frailty worsens HF prognosis by reducing treatment tolerance (e.g.,beta-blocker-induced hypotension) and increasing readmissions (>30%).Frailty independently predicts HF mortality (HR 2.41).Integrated management requires:exercise and nutrition optimization for frailty;individualized pharmacotherapy and judicious device selection for HF;multidisciplinary interventions targeting quality of life and remote monitoring (15% readmission reduction).This article aims to systematically elaborate on the interactive mechanism between frailty and heart failure in the elderly,as well as clinical management strategies. |
|
查看全文
|
| 关闭 |
|
|
|