摘要：

慢性心力衰竭作为一种复杂综合征, 其病理生理学特征之一是神经-体液系统异常激活, 尤其是交感神经过度兴奋和肾素-血管紧张素-醛固酮系统持续激活。同时, 慢性心力衰竭致心输出量下降可导致脑低灌注, 显著影响认知功能; 反之, 脑低灌注致认知功能下降可加重心功能障碍, 提示心脑之间存在密切的双向调控关系。本文旨在系统探讨慢性心力衰竭与神经系统之间的相互影响机制, 从生理状态下神经-体液调节对心血管功能的调控, 慢性心力衰竭过程中自主神经调节失衡、神经-体液调节紊乱及神经代偿机制失能, 慢性心力衰竭对认知功能的损害等多个维度阐述其病理生理学基础, 为临床实现脑心同治提供理论支持与实践指导。

关键词: 心力衰竭, 慢性病, 神经系统, 体液, 肾素-血管紧张素系统, 脑心同治（非MeSH词）, 综述

Abstract:

Chronic heart failure (CHF) is a complex syndrome, one of whose pathophysiological features is the abnormal activation of the neurohumoral system, especially the excessive excitation of the sympathetic nerve and the continuous activation of the renin-angiotensin-aldosterone system (RAAS). At the same time, the decreased cardiac output caused by chronic heart failure can lead to cerebral hypoperfusion and significantly affect cognitive function; conversely, cognitive impairment caused by cerebral hypoperfusion could exacerbate cardiac dysfunction, suggesting a close bidirectional regulatory relationship between the heart and the brain. This article aims to systematically explore the mutual influence mechanism between chronic heart failure and the nervous system, elaborating on its pathophysiological basis from multiple dimensions such as the regulation of cardiovascular function by neurohumoral regulation under physiological conditions, the pathological mechanism of autonomic nerve imbalance, neurohumoral disorder and dysfunction of neuro-compensation mechanism during the development of chronic heart failure, and the damage of chronic heart failure to cognitive function, and providing theoretical support and practical guidance for the clinical realization of treatment for brain and heart.

Key words: eart failure, Chronic disease, Nervous system, Body fluids, Renin-angiotensin system, Treatment for brain and heart (not in MeSH), Review