心力衰竭及其常见治疗方案丨医学英语视听学习

Heart Failure and Common Treatment Options

心力衰竭及其常见治疗方案

In the normal heart, deoxygenated blood flows from the body through the superior and inferior vena cava into the right atrium. 

在正常心脏中，脱氧血液从身体，通过上腔静脉和下腔静脉，流入右心房。

The blood, a volume known as preload, then moves into the right ventricle, which contracts and sends blood out of the heart and into the lungs to remove carbon dioxide and collect oxygen. 

然后，血液，即称为前负荷的容量，进入右心室，右心室收缩，将血液从心脏泵出到肺，从而清除 CO2，并收集 O2。

Oxygenated blood moves from the lungs into the left atrium, then moves into the left ventricle which contracts and propels oxygenated blood out of the heart and into the systemic circulation against resistance known as afterload. 

充氧血液从肺进入左心房，然后进入左心室，左心室收缩，推动充氧血液从心脏排出，抵抗称为后负荷的阻力，进入体循环。

When the heart losses its ability to pump enough blood to meet its needs or those of the body, the diagnosis is heart failure. 

当心脏失去泵送足够的血液，满足自身或身体需求的能力时，诊断为心力衰竭。

In left-sided heart failure, the left ventricle does not pump an adequate volume of oxygenated blood into the systemic circulation. Left-sided heart failure causes pulmonary congestion, a buildup of blood and fluid in the lung tissues that interferes with respiration. 

左侧心力衰竭指左心室不能将足够的含氧血液泵入体循环。左侧心力衰竭会导致肺充血，即血液和液体在肺组织内积聚，干扰呼吸。

In response to the low levels of oxygen, the heart rate increases to compensate for the left ventricle's weakened state and to meet the body's oxygen demands, which in time leads to thickening, or hypertrophy, of the myocardium as it labors to push blood out of the heart against the increasing pressure in the pulmonary vessels and fluid in the lungs and continuing the cycle of cardiac muscle damage. 

在低水平氧气刺激下，心率加快，从而补偿左心室的衰弱状态，满足身体的氧需求，随着左心室努力抵抗肺血管和肺内液体不断增加的压力，将血液泵出心脏，以及心肌不断损伤，最终会导致心肌增厚或肥大。

In right-sided heart failure, the right ventricle is unable to contract with enough force to drive enough blood through the pulmonary arteries to the lungs for oxygenation. 

右侧心力衰竭指右心室不能充分收缩，将足够的血液通过肺动脉输送到肺，进行充氧。

Right-sided heart failure results in a buildup of blood in the venous circulation, causing fluid retention called edema throughout the body. Deprived of sufficient blood flow, the kidneys fail to filter excessive sodium and water from the blood, leading to a fluid imbalance and increased vascular resistance against which the heart must pump. The result is perpetual damage to the heart's overworked tissues. 

右侧心力衰竭会导致静脉循环内的血液积聚，引起液体潴留，导致全身水肿。由于血流不足，肾脏无法过滤血液中过多的钠和水，导致液体失衡，以及心脏泵血必须克服的血管阻力增加。这会导致心脏组织过度做功，造成永久性损伤。

Treatment for heart failure involves changes in lifestyle such as diet and exercise, medication, surgery, or a combination of approaches. Commonly, therapies for right-sided heart failure are geared toward improving left sided cardiac function. 

心力衰竭的治疗方法包括生活方式改变，如饮食和锻炼、药物、手术或多种方法组合。通常，右侧心力衰竭的治疗旨在改善左侧心脏功能。

In heart failure, an increase in fluid volume places added stress on the overloaded heart. Diuretic medications reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system, increasing the amounts of sodium and water excreted in the urine and the volume of urine produced. 

发生心力衰竭时，液体体积增加会对超负荷的心脏施加额外的压力。利尿药物通过抑制钠和水沿肾小管系统重吸收，增加尿液中钠和水的排泄量，以及产生的尿量，从而减少液体量和静脉血回流。

ACE inhibitors block hormones in the renin-angiotensin-aldosterone system, dilating vessels, lowering blood volume and venous return, decreasing the heart's workload, and halting ventricular hypertrophy. 

ACE 抑制剂阻断肾素-血管紧张素-醛固酮系统中的激素，扩张血管，降低血容量和静脉回流，减少心脏工作量，阻止心室肥大。

Digoxin is a medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations. To compensate for the decreased cardiac output in heart failure, the sympathetic nervous system initiates norepinephrine release, raising the overworked heart's rate and force of contractions. 

地高辛是一种通过提高细胞内钠和钙浓度来增加心肌收缩力的药物。为补偿心力衰竭时心输出量的减少，交感神经系统开始释放去甲肾上腺素，加快心率和收缩力。

Beta-blockers are prescribed to compete with norepinephrine molecules for binding sites on cardiomyocytes, preventing norepinephrine's effects, resulting in reduced speed and strength of the contractions, which can support more efficient circulation through the body. 

β 受体阻滞剂用于与去甲肾上腺素分子竞争心肌细胞上的结合位点，阻止去甲肾上腺素的作用，导致收缩的速度和强度降低，从而支持更有效的体内循环。