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交感神经与心源性猝死
刘鹏1,刘腾飞2,黄颖1,王昊1,廖德宁1*
0
(1.第二军医大学长征医院心内科,上海 200003
2.第二军医大学长征医院胸心外科,上海 200003
*通信作者)
摘要:
心源性猝死(sudden cardiac death, SCD)指因心血管原因造成的,突然发病1 h内或距离最后所知稳定状态24 h内的死亡,发病率高、存活率低。心脏自主神经尤其交感神经与SCD的关系是目前相关研究的焦点。交感神经兴奋性异常增高、交感神经分布不均及病理状态下的重塑均会造成心律失常易感性增高甚至诱发心源性猝死。药物治疗、植入型心律转复除颤器(implanted cardioverter defibrillator, ICD)预防及近年先后出现的星状神经节切除、肾动脉神经消融、脊髓刺激等均对减少心源性猝死的发生起到一定作用。因此,本文就心源性猝死与交感神经的关系以及相关的治疗措施作一综述。
关键词:  心源性猝死  自主神经  交感神经  去神经支配
DOI:
投稿时间:2013-03-19修订日期:2013-06-27
基金项目:国家自然科学基金(81270244),第二军医大学创新基金重点项目(ZD2012001).
Sympathetic nerves and its relationship with sudden cardiac death
LIU Peng1,LIU Teng-fei2,HUANG Ying1,WANG Hao1,LIAO De-ning1*
(1. Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
2. Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author.)
Abstract:
Sudden cardiac death (SCD) refers to death within 1 hour after onset of cardiovascular disease or death within 24 hours from the last stable status. SCD has a high incidence and mortality rate. The relationship between heart autonomic nerves, especially sympathetic nerve and SCD, is the focus of study. The increase and/or heterogeneity of sympathetic activity and the remodeling of sympathetic innervation can lead to arrhythmogenic substrate in the heart or even SCD. Medicine treatment, implanted cardioverter defibrillator, left cardiac sympathetic denervation, renal sympathtic nerves ablation and spine stimulation have obtained encouraging outcomes. Therefore the present paper reviews the autonomic system, especially sympathetic nerves, and its relationship with cardiac arrhythmia.
Key words:  sudden cardiac death  autonomic nerve  sympathetic nerve  denervation