近10年来,随着对心力衰竭的病理生理特别是对血管因素的深入了解,提倡用血管扩张剂,为治疗心力衰竭开辟了一条新途径,使许多严重的充血性心力衰竭,尤其是一些过去认为是难治性的心力衰竭和并发于急性心肌梗塞的泵衰竭的预后有所改善。但血管扩张剂如使用不当,可导致血压及心排血量骤减而致严重的不良后果。本文综述扩血管疗法的理论基础和常用的血管扩张剂及其临床应用。一、扩血管疗法的理论基础心排血量的主要决定因素是:1.心肌收缩力;2.心率;3.前负荷;4.后负荷.后两者为决定心脏功能的周围血管因素。心排血量决定因素的改变,可影响心脏功能,特别是周围血管因素的改变.如左心室功能曲线(图1)显示,随着心室充盈压的增加,每搏量也增加,但到 In the past 10 years, with the deep understanding of the pathophysiology of heart failure, especially the vascular factors, the promotion of vasodilators has opened up a new way for the treatment of heart failure and made many serious congestive heart failure, especially some past The prognosis for refractory heart failure and pump failure associated with acute myocardial infarction is improved. However, improper use of vasodilators can lead to serious adverse consequences such as sudden drop in blood pressure and cardiac output. This article reviews the theoretical basis of vasodilator therapy and commonly used vasodilators and their clinical applications. First, the theoretical basis of vasodilator therapy The main determinant of cardiac output is: 1. Myocardial contractility; 2. Heart rate; 3. Pre-load; 4. After-load. The latter two to determine the function of the heart of peripheral vascular factors. Changes in the determinants of cardiac output may affect cardiac function, especially changes in peripheral vascular factors such as left ventricular function curve (Figure 1) shows that as the ventricular filling pressure increases, stroke volume also increased, but to