射血分数保留的心力衰竭合并抑郁的临床治疗进展

doi:10.12114/j.issn.1007-9572.2022.0315

中国全科医学 ›› 2022, Vol. 25 ›› Issue (33): 4196-4202.DOI: 10.12114/j.issn.1007-9572.2022.0315

所属专题：心力衰竭最新文章合辑；心血管最新文章合辑；精神卫生最新文章合辑

射血分数保留的心力衰竭合并抑郁的临床治疗进展

刘先玲¹, 洪牮¹, 王凯², 钱丽君¹, 孙燕¹, 马文杰¹, 李钟鸣¹, 许迪¹^,^*()

1.210029　江苏省南京市，南京医科大学第一附属医院老年医学科
2.210029　江苏省南京市，南京医科大学第一附属医院心血管内科

收稿日期:2022-04-29 修回日期:2022-05-18 出版日期:2022-11-20 发布日期:2022-06-20
通讯作者: 许迪
刘先玲，洪牮，王凯，等.射血分数保留的心力衰竭合并抑郁的临床治疗进展[J].中国全科医学，2022，25（33）：4196-4202. [www.chinagp.net]
作者贡献：刘先玲负责文章的构思与设计、撰写论文；洪牮、王凯负责论文的修订；钱丽君、马文杰负责文献收集；孙燕、李钟鸣负责文献整理；许迪负责文章的质量控制及审校，对文章整体负责、监督管理。
基金资助:
国家自然科学基金资助项目(81871359)

Progress in Clinical Treatment of Heart Failure with Preserved Ejection Fraction Combined with Depression

LIU Xianling¹, HONG Jian¹, WANG Kai², QIAN Lijun¹, SUN Yan¹, MA Wenjie¹, LI Zhongming¹, XU Di¹^,^*()

1.Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
2.Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Received:2022-04-29 Revised:2022-05-18 Published:2022-11-20 Online:2022-06-20
Contact: XU Di
About author:
LIU X L, HONG J, WANG K, et al. Progress in clinical treatment of heart failure with preserved ejection fraction combined with depression[J]. Chinese General Practice, 2022, 25 (33) : 4196-4202.

分享到

摘要/Abstract

摘要： 射血分数保留的心力衰竭（HFpEF）是心力衰竭（HF）的一种常见类型，由于其病理生理机制不同，以往将针对射血分数减低的心力衰竭（HFrEF）的治疗方法应用于HFpEF患者的疗效并不理想，以致患者预后差、病死率高。抑郁是由各种原因引起的、以明显而持久的情绪低落为主要临床特征的一类常见的精神心理疾病。抑郁患者常伴有不同程度的认知和行为改变，病情严重者甚至会出现自伤、自杀行为。随着对HFpEF的深入研究，人们发现抑郁已成为HFpEF常见的合并症之一，且两者的相互作用可导致患者预后不良。目前有关HFpEF合并抑郁的研究表明，部分药物可改善此类患者短期症状及临床预后。本文通过总结、归纳HFpEF合并抑郁的共病机制、研究现况及相关治疗的最新进展，发现钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂、血管紧张素受体脑啡肽酶抑制剂（ARNI）、他汀类药物在治疗HF及精神心理领域方面扮演着重要角色，不仅能改善HFpEF患者心功能及其预后，还具有抗抑郁的效果，能为临床研究及治疗提供参考。

关键词: 心力衰竭, 抑郁, 共病现象, 射血分数保留的心力衰竭, 临床治疗, 综述

Abstract:

Heart failure with preserved ejection fraction (HFpEF) is a common type of heart failure (HF) , and previous treatments that primarily target heart failure with reduced ejection fraction (HFrEF) do not benefit the patients with HFpEF because of the differences in their pathophysiological mechanisms, resulting in high mortality and poor prognosis. Whereas depression is one of the most common mental and psychological problems, caused by various reasons and characterized by a pronounced and long-lasting low spirits, with various degrees of cognitive and behavioral changes. Those who are severely ill even present self-injurious and suicidal behavior. With intensive research into HFpEF, it has emerged that depression has become one of the most common comorbidities in HFpEF and that the two interact to contribute to poor prognosis for patients. Currently, relevant studies in HFpEF with depression suggested that some drugs could improve short term symptoms and clinical prognosis in such patients. This paper aimed to review the comorbid mechanism, research status and the latest progress of related treatment of HFpEF complicated with depression. It is found that sodium glucose cotransporter 2 (SGLT2) inhibitors, angiotensin receptor enkephalinase inhibitors (ARNI) and statin drugs play important roles in the field of HF and psychophysiology. They can not only improve the cardiac function and prognosis of HFpEF patients, but also have the effect of anti-depression, thus to provide references for clinical study and treatment.

Key words: Heart failure, Depression, Comorbidity, Heart failure with preserved ejection fraction, Clinical treatment, Review

刘先玲,洪牮,王凯,等. 射血分数保留的心力衰竭合并抑郁的临床治疗进展[J]. 中国全科医学, 2022, 25(33): 4196-4202. DOI: 10.12114/j.issn.1007-9572.2022.0315.
LIU Xianling,HONG Jian,WANG Kai, et al. Progress in Clinical Treatment of Heart Failure with Preserved Ejection Fraction Combined with Depression[J]. Chinese General Practice, 2022, 25(33): 4196-4202. DOI: 10.12114/j.issn.1007-9572.2022.0315.

图/表 1

参考文献 70

[1]	MCDONAGH T A, METRA M, ADAMO M，et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J，2021，42(36):3599-3726. DOI：10.1093/eurheartj/ehab368.
[2]	LAM C S, DONAL E, KRAIGHER-KRAINER E，et al. Epidemiology and clinical course of heart failure with preserved ejection fraction[J]. Eur J Heart Fail，2011，13(1):18-28.
[3]	PAGEL P S, TAWIL J N, BOETTCHER B T，et al. Heart failure with preserved ejection fraction：a comprehensive review and update of diagnosis，pathophysiology，treatment，and perioperative implications[J]. J Cardiothorac Vasc Anesth，2021，35(6):1839-1859. DOI：10.1053/j.jvca.2020.07.016.
[4]	胡大一. 如何在心脏中心开展"双心"服务[J]. 中华心血管病杂志，2013，41(8):633.
[5]	刘梅颜. 双心医学：精神心理因素引发心脏损伤[J]. 中华内科杂志，2017，56(11):857-858. DOI：10.3760/cma.j.issn.0578-1426.2017.11.018.
[6]	SUZUKI T, SHIGA T, KUWAHARA K，et al. Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure[J]. J Cardiol，2014，64(6):456-462. DOI：10.1016/j.jjcc.2014.02.031.
[7]	温雪梅，卢仁泉，郭林. 中国心力衰竭患者抑郁焦虑发病及干预效果的Meta分析[J]. 中华临床医师杂志（电子版），2014，8(4):702-709. DOI：10.3877/cma.j.issn.1674-0785.2014.04.027.
[8]	GRIPPO A J, JOHNSON A K. Stress，depression and cardiovascular dysregulation：a review of neurobiological mechanisms and the integration of research from preclinical disease models[J]. Stress，2009，12(1):1-21. DOI：10.1080/10253890802046281.
[9]	BROTMAN D J, GOLDEN S H, WITTSTEIN I S. The cardiovascular toll of stress[J]. Lancet，2007，370(9592):1089-1100. DOI：10.1016/S0140-6736(07)61305-1.
[10]	DUNLAY S M, ROGER V L, REDFIELD M M. Epidemiology of heart failure with preserved ejection fraction[J]. Nat Rev Cardiol，2017，14(10):591-602. DOI：10.1038/nrcardio.2017.65.
[11]	PAULUS W J, TSCHÖPE C. A novel paradigm for heart failure with preserved ejection fraction：comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation[J]. J Am Coll Cardiol，2013，62(4):263-271. DOI：10.1016/j.jacc.2013.02.092.
[12]	FELGER J C, LOTRICH F E. Inflammatory cytokines in depression：neurobiological mechanisms and therapeutic implications[J]. Neuroscience，2013，246:199-229. DOI：10.1016/j.neuroscience.2013.04.060.
[13]	SU J, WANG J H, MA Y Y，et al. Inflammation associated with chronic heart failure leads to enhanced susceptibility to depression[J]. FEBS J，2019，286(14):2769-2786. DOI：10.1111/febs.14839.
[14]	ZHAO X N, CAO F R, LIU Q，et al. Behavioral，inflammatory and neurochemical disturbances in LPS and UCMS-induced mouse models of depression[J]. Behav Brain Res，2019，364:494-502. DOI：10.1016/j.bbr.2017.05.064.
[15]	DICKENS C. Depression in people with coronary heart disease：prognostic significance and mechanisms[J]. Curr Cardiol Rep，2015，17(10):83. DOI：10.1007/s11886-015-0640-6.
[16]	SCHERF-CLAVEL M, WURST C, NITSCHKE F，et al. Extent of cortisol suppression at baseline predicts improvement in HPA axis function during antidepressant treatment[J]. Psychoneuroendocrinology，2020，114:104590. DOI：10.1016/j.psyneuen.2020.104590.
[17]	曹娟，刘习建，龚婷，等. 冠心病与抑郁症共病机制及治疗的研究进展[J]. 生命的化学，2019，39(5):993-997. DOI：10.13488/j.smhx.20190009.
[18]	SAMA J, VAIDYA D, MUKHERJEE M，et al. Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome[J]. J Thromb Thrombolysis，2021，51(3):693-700. DOI：10.1007/s11239-020-02268-4.
[19]	龚山，王龙飞，余国龙. 心血管疾病患者使用抗抑郁焦虑药物效益与风险评估[J]. 医药导报，2018，37(10):1194-1198. DOI：10.3870/j.issn.1004-0781.2018.10.010.
[20]	唐梅，李向平. 抗抑郁药的不良反应及其在心血管病患者中的应用[J]. 中南大学学报（医学版），2020，45(10):1228-1233. DOI：10.11817/j.issn.1672-7347.2020.190160.
[21]	郭宁红，刘萧，李帅，等. 抗抑郁药与心力衰竭患者死亡率关系的荟萃分析[J]. 临床心血管病杂志，2018，34(2):142-146. DOI：10.13201/j.issn.1001-1439.2018.02.010.
[22]	YUSUF S, PFEFFER M A, SWEDBERG K，et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction：the CHARM-Preserved Trial[J]. Lancet，2003，362(9386):777-781. DOI：10.1016/S0140-6736(03)14285-7.
[23]	RECTOR T S, CARSON P E, ANAND I S，et al. Assessment of long-term effects of irbesartan on heart failure with preserved ejection fraction as measured by the Minnesota living with heart failure questionnaire in the irbesartan in heart failure with preserved systolic function（I-PRESERVE） trial[J]. Circ Heart Fail，2012，5(2):217-225. DOI：10.1161/CIRCHEARTFAILURE.111.964221.
[24]	YAMAMOTO K, ORIGASA H, HORI M，et al. Effects of carvedilol on heart failure with preserved ejection fraction：the Japanese Diastolic Heart Failure Study（J-DHF）[J]. Eur J Heart Fail，2013，15(1):110-118. DOI：10.1093/eurjhf/hfs141.
[25]	PITT B, PFEFFER M A, ASSMANN S F，et al. Spironolactone for heart failure with preserved ejection fraction[J]. N Engl J Med，2014，370(15):1383-1392. DOI：10.1056/NEJMoa1313731.
[26]	NASSIF M E, WINDSOR S L, BORLAUG B A，et al. The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction：a multicenter randomized trial[J]. Nat Med，2021，27(11):1954-1960. DOI：10.1038/s41591-021-01536-x.
[27]	MUHAMMAD R N, AHMED L A, ABDUL SALAM R M，et al. Crosstalk among NLRP3 inflammasome，ET B R signaling，and miRNAs in stress-induced depression-like behavior：a modulatory role for SGLT2 inhibitors[J]. Neurotherapeutics，2021，18(4):2664-2681. DOI：10.1007/s13311-021-01140-4.
[28]	PIESKE B, WACHTER R, SHAH S J，et al. Effect of sacubitril/valsartan vs standard medical therapies on plasma NT-proBNP concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction：the PARALLAX randomized clinical trial[J]. JAMA，2021，326(19):1919-1929. DOI：10.1001/jama.2021.18463.
[29]	MALIK J, SHAHID A W, SHAH M，et al. Outcome of angiotensin receptor-neprilysin inhibitor on anxiety and depression in heart failure with reduced ejection fraction vs. heart failure with preserved ejection fraction[J]. J Community Hosp Intern Med Perspect，2021，11(5):629-634. DOI：10.1080/20009666.2021.1942623.
[30]	PACKER M. Drugs that ameliorate epicardial adipose tissue inflammation may have discordant effects in heart failure with a preserved ejection fraction as compared with a reduced ejection fraction[J]. J Card Fail，2019，25(12):986-1003. DOI：10.1016/j.cardfail.2019.09.002.
[31]	TANIGUTI E H, FERREIRA Y S, STUPP I J V，et al. Atorvastatin prevents lipopolysaccharide-induced depressive-like behaviour in mice[J]. Brain Res Bull，2019，146:279-286. DOI：10.1016/j.brainresbull.2019.01.018.
[32]	KOSIBOROD M N, JHUND P S, DOCHERTY K F，et al. Effects of dapagliflozin on symptoms，function，and quality of life in patients with heart failure and reduced ejection fraction：results from the DAPA-HF trial[J]. Circulation，2020，141(2):90-99. DOI：10.1161/CIRCULATIONAHA.119.044138.
[33]	NASSIF M E, WINDSOR S L, TANG F M，et al. Dapagliflozin effects on biomarkers，symptoms，and functional status in patients with heart failure with reduced ejection fraction：the DEFINE-HF trial[J]. Circulation，2019，140(18):1463-1476. DOI：10.1161/CIRCULATIONAHA.119.042929.
[34]	PACKER M, ANKER S D, BUTLER J，et al. Cardiovascular and renal outcomes with empagliflozin in heart failure[J]. N Engl J Med，2020，383(15):1413-1424. DOI：10.1056/NEJMoa2022190.
[35]	BHATT D L, SZAREK M, STEG P G，et al. Sotagliflozin in patients with diabetes and recent worsening heart failure[J]. N Engl J Med，2021，384(2):117-128. DOI：10.1056/NEJMoa2030183.
[36]	COMMITTEE W, MADDOX T M, JANUZZI J L Jr，et al. 2021 update to the 2017 ACC expert consensus decision pathway for optimization of heart failure treatment：answers to 10 pivotal issues about heart failure with reduced ejection fraction：a report of the American college of cardiology solution set oversight committee[J]. J Am Coll Cardiol，2021，77(6):772-810. DOI：10.1016/j.jacc.2020.11.022.
[37]	ABRAHAM W T, LINDENFELD J, PONIKOWSKI P，et al. Effect of empagliflozin on exercise ability and symptoms in heart failure patients with reduced and preserved ejection fraction，with and without type 2 diabetes[J]. Eur Heart J，2021，42(6):700-710. DOI：10.1093/eurheartj/ehaa943.
[38]	ANKER S D, BUTLER J, FILIPPATOS G，et al. Empagliflozin in heart failure with a preserved ejection fraction[J]. N Engl J Med，2021，385(16):1451-1461. DOI：10.1056/NEJMoa2107038.
[39]	刘蔚，尉然. 射血分数保留的心力衰竭的诊断和治疗策略[J]. 中国全科医学，2021，24(3):253-258. DOI：10.12114/j.issn.1007-9572.2020.00.603.
[40]	ISHII M, KAIKITA K, SATO K，et al. Cardioprotective effects of LCZ696（sacubitril/valsartan） after experimental acute myocardial infarction[J]. JACC Basic Transl Sci，2017，2(6):655-668. DOI：10.1016/j.jacbts.2017.08.001.
[41]	CHANDRA A, LEWIS E F, CLAGGETT B L，et al. Effects of sacubitril/valsartan on physical and social activity limitations in patients with heart failure：a secondary analysis of the PARADIGM-HF trial[J]. JAMA Cardiol，2018，3(6):498-505. DOI：10.1001/jamacardio.2018.0398.
[42]	MANN D L, GREENE S J, GIVERTZ M M，et al. Sacubitril/valsartan in advanced heart failure with reduced ejection fraction：rationale and design of the LIFE trial[J]. JACC Heart Fail，2020，8(10):789-799. DOI：10.1016/j.jchf.2020.05.005.
[43]	SOLOMON S D, MCMURRAY J J V, ANAND I S，et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction[J]. N Engl J Med，2019，381(17):1609-1620. DOI：10.1056/NEJMoa1908655.
[44]	CACCIATORE F, AMARELLI C, MAIELLO C，et al. Effect of Sacubitril-Valsartan in reducing depression in patients with advanced heart failure[J]. J Affect Disord，2020，272:132-137. DOI：10.1016/j.jad.2020.03.158.
[45]	PINAL-FERNANDEZ I, CASAL-DOMINGUEZ M, MAMMEN A L. Statins：pros and cons[J]. Med Clin（Barc），2018，150(10):398-402. DOI：10.1016/j.medcli.2017.11.030.
[46]	Cholesterol Treatment Trialists'（CTT） Collaboration, BAIGENT C, BLACKWELL L，et al. Efficacy and safety of more intensive lowering of LDL cholesterol：a meta-analysis of data from 170，000 participants in 26 randomised trials[J]. Lancet，2010，376(9753):1670-1681. DOI：10.1016/S0140-6736(10)61350-5.
[47]	MILLS E J, O'REGAN C, EYAWO O，et al. Intensive statin therapy compared with moderate dosing for prevention of cardiovascular events：a Meta-analysis of>40 000 patients[J]. Eur Heart J，2011，32(11):1409-1415. DOI：10.1093/eurheartj/ehr035.
[48]	GÓMEZ-GARRE D, GONZÁLEZ-RUBIO M L, MUÑOZ-PACHECO P，et al. Rosuvastatin added to standard heart failure therapy improves cardiac remodelling in heart failure rats with preserved ejection fraction[J]. Eur J Heart Fail，2010，12(9):903-912. DOI：10.1093/eurjhf/hfq101.
[49]	LIU G, ZHENG X X, XU Y L，et al. Meta-analysis of the effect of statins on mortality in patients with preserved ejection fraction[J]. Am J Cardiol，2014，113(7):1198-1204. DOI：10.1016/j.amjcard.2013.12.023.
[50]	YOUNG-XU Y, CHAN K A, LIAO J K，et al. Long-term statin use and psychological well-being[J]. J Am Coll Cardiol，2003，42(4):690-697. DOI：10.1016/s0735-1097(03)00785-x.
[51]	HAGHIGHI M, KHODAKARAMI S, JAHANGARD L，et al. In a randomized，double-blind clinical trial，adjuvant atorvastatin improved symptoms of depression and blood lipid values in patients suffering from severe major depressive disorder[J]. J Psychiatr Res，2014，58:109-114. DOI：10.1016/j.jpsychires.2014.07.018.
[52]	REDLICH C, BERK M, WILLIAMS L J，et al. Statin use and risk of depression：a Swedish national cohort study[J]. BMC Psychiatry，2014，14:348. DOI：10.1186/s12888-014-0348-y.
[53]	TEPLY R M, PACKARD K A, WHITE N D，et al. Treatment of depression in patients with concomitant cardiac disease[J]. Prog Cardiovasc Dis，2016，58(5):514-528. DOI：10.1016/j.pcad.2015.11.003.
[54]	张雄，张灵丽，姜蕊琪. 艾司西酞普兰与舍曲林治疗抑郁症的疗效与安全性的Meta分析[J]. 医药导报，2021，40(9):1253-1260. DOI：10.3870/j.issn.1004-0781.2021.09.017.
[55]	曹选超，刘祥，徐先静，等. 艾司西酞普兰治疗老年人射血分数保留性心力衰竭伴抑郁障碍的疗效及安全性[J]. 中华老年医学杂志，2020，39(12):1406-1410. DOI：10.3760/cma.j.issn.0254-9026.2020.12.009.
[56]	O'CONNOR C M, JIANG W, KUCHIBHATLA M，et al. Safety and efficacy of sertraline for depression in patients with heart failure：results of the SADHART-CHF（Sertraline Against Depression and Heart Disease in Chronic Heart Failure） trial[J]. J Am Coll Cardiol，2010，56(9):692-699. DOI：10.1016/j.jacc.2010.03.068.
[57]	ANGERMANN C E, GELBRICH G, STÖRK S，et al. Effect of escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression：the MOOD-HF randomized clinical trial[J]. JAMA，2016，315(24):2683-2693. DOI：10.1001/jama.2016.7635.
[58]	DAS A, ROY B, SCHWARZER G，et al. Comparison of treatment options for depression in heart failure：a network meta-analysis[J]. J Psychiatr Res，2019，108:7-23. DOI：10.1016/j.jpsychires.2018.10.007.
[59]	PIEPOLI M F. Exercise training in chronic heart failure：mechanisms and therapies[J]. Neth Heart J，2013，21(2):85-90. DOI：10.1007/s12471-012-0367-6.
[60]	MORGAN W P. Affective beneficence of vigorous physical activity[J]. Med Sci Sports Exerc，1985，17(1):94-100.
[61]	TANG S W, STANCER H C, TAKAHASHI S，et al. Controlled exercise elevates plasma but not urinary MHPG and VMA[J]. Psychiatry Res，1981，4(1):13-20. DOI：10.1016/0165-1781(81)90003-2.
[62]	FREEDLAND K E, CARNEY R M, RICH M W，et al. Cognitive behavior therapy for depression and self-care in heart failure patients：a randomized clinical trial[J]. JAMA Intern Med，2015，175(11):1773-1782. DOI：10.1001/jamainternmed.2015.5220.
[63]	GARY R A, DUNBAR S B, HIGGINS M K，et al. Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure[J]. J Psychosom Res，2010，69(2):119-131. DOI：10.1016/j.jpsychores.2010.01.013.
[64]	SULLIVAN M J, WOOD L, TERRY J，et al. The Support，Education，and Research in Chronic Heart Failure Study（SEARCH）：a mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure[J]. Am Heart J，2009，157(1):84-90. DOI：10.1016/j.ahj.2008.08.033.
[65]	孔凡贞，钮美娥，赵惠英，等. 正念认知疗法在抑郁症患者中的研究现状[J]. 中华护理杂志，2015，50(12):1502-1505. DOI：10.3761/j.issn.0254-1769.2015.12.018.
[66]	朱训明，吴强强. 放松疗法应用于老年慢性充血性心衰患者焦虑、抑郁情绪改善效果分析[J]. 中国健康心理学杂志，2018，26(9):1419-1422. DOI：10.13342/j.cnki.cjhp.2018.09.037.
[67]	REDDY Y N V, ANDERSEN M J, OBOKATA M，et al. Arterial stiffening with exercise in patients with heart failure and preserved ejection fraction[J]. J Am Coll Cardiol，2017，70(2):136-148. DOI：10.1016/j.jacc.2017.05.029.
[68]	刘义，冯慧，毛洪京，等. 针刺联合西药对初发抑郁障碍患者血清5-HT及TH1/TH2的影响[J]. 中国针灸，2015，35(6):539-543. DOI：10.13703/j.0255-2930.2015.06.003.
[69]	黄渺苗，崔燕. 针刺治疗双心疾病的作用机制研究概述[J]. 中西医结合心脑血管病杂志，2019，17(21):3348-3351. DOI：10.12102/j.issn.1672-1349.2019.21.020.
[70]	刘芳，朱越琪. 穴位刺激调控对抑郁症患者心率变异及心电图特征的影响[J]. 中国医药导报，2014，11(29):31-34.

射血分数保留的心力衰竭合并抑郁的临床治疗进展

Progress in Clinical Treatment of Heart Failure with Preserved Ejection Fraction Combined with Depression

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 1

参考文献 70

相关文章 15

编辑推荐

Metrics

留言

[1]	王婷婷, 唐勇, 张文轲, 李志刚. 高尿酸血症运动干预的研究进展[J]. 中国全科医学, 2025, 28(30): 3841-3846.
[2]	马双双, 邢岩江, 张佳玮, 王婧. 心力衰竭中心脏能量代谢变化研究进展[J]. 中国全科医学, 2025, 28(30): 3831-3840.
[3]	周晟, 邓长生, 邹冠炀, 宋健平. 疟疾心血管疾病并发症发病机制的研究进展[J]. 中国全科医学, 2025, 28(27): 3466-3472.
[4]	刘振宇, 魏云鹏, 王江敏, 邢彦. 睡眠时间与心力衰竭的因果关联研究[J]. 中国全科医学, 2025, 28(27): 3441-3446.
[5]	黄雨琳, 王浩云, 李燕梅, 萧雪英. 胃癌患者化疗期间症状群的范围综述[J]. 中国全科医学, 2025, 28(26): 3338-3344.
[6]	顾小林, 陈俊屿, 陈丹, 韩广莉, 陈衣迪, 李春宏, 罗小茜. 农村女性妊娠期负性情绪体验的质性研究[J]. 中国全科医学, 2025, 28(26): 3283-3288.
[7]	刘文洁, 孙煌, 罗薇, 陈旋, 彭云珠, 李锐洁, 马米尔. 可穿戴式心音心电远程监测设备用于心力衰竭的研究[J]. 中国全科医学, 2025, 28(25): 3104-3109.
[8]	杨晨, 陈瞳, 张利方, 张洪旭, 李鹏飞, 张雪娟. 达格列净对老年乳腺癌幸存者射血分数保留的心力衰竭合并2型糖尿病患者的预后影响研究[J]. 中国全科医学, 2025, 28(24): 3053-3058.
[9]	韩冰, 杜淑珍, 孟晓雪, 张璐, 陈梓娴, 滕凤玲. 心力衰竭患者血浆骨膜蛋白水平与心肌纤维化的相关性研究[J]. 中国全科医学, 2025, 28(24): 2979-2984.
[10]	刘银银, 隋鸿平, 李婷婷, 姜桐桐, 史铁英, 夏云龙. 乳腺癌治疗相关心脏毒性风险预测模型的研究进展[J]. 中国全科医学, 2025, 28(24): 3072-3078.
[11]	李苗秀, 朱博文, 孔令军, 房敏. 青少年脊柱侧弯保守治疗临床评估工具研究进展[J]. 中国全科医学, 2025, 28(24): 3079-3088.
[12]	肖瑶, 万钧. 直接口服抗凝药在静脉血栓栓塞特殊人群中的临床应用[J]. 中国全科医学, 2025, 28(24): 3066-3071.
[13]	阮万百, 李俊峰, 尹艳梅, 彭磊, 朱克祥. 胰腺癌靶向治疗及免疫治疗的研究新进展[J]. 中国全科医学, 2025, 28(23): 2950-2960.
[14]	周连鹏, 李伟峰, 董新刚, 王晓元. 铜稳态调节机制在认知障碍中的作用探析[J]. 中国全科医学, 2025, 28(23): 2941-2949.
[15]	尉晓霞, 陈诺, 王娟娟, 朱静芬. 职校生抑郁和焦虑情绪对吸烟行为的影响研究[J]. 中国全科医学, 2025, 28(22): 2826-2832.