Doehner Wolfram, von Haehling Stephan, Anker Stefan D, Lainscak Mitja
Center for Stroke Research Berlin, Charité, Berlin, Germany.
Wien Klin Wochenschr. 2009;121(9-10):293-6. doi: 10.1007/s00508-009-1194-7.
Chronic cardiopulmonary disease typically induces and maintains (over)activation of several phylogenetically old adaptational and defensive mechanisms. Activation was usually needed for a limited period during acute danger or injury. In chronic disease conditions, however, those mechanisms are kept activated for longer periods. Eventually, irreversible damage is done and this contributes to impaired function and worse prognosis in a variety of chronic disease. Landmark trials in chronic heart failure have provided robust evidence for prognostic benefit for neurohormonal antagonists. Retrospective and epidemiological data for their beneficial effect in chronic obstructive pulmonary disease begin to accumulate and new fields (e.g. cancer and stroke) could be pending in the future.
慢性心肺疾病通常会引发并维持（过度）激活多种进化上古老的适应性和防御机制。在急性危险或损伤期间，通常在有限的时间段内需要激活这些机制。然而，在慢性疾病状态下，这些机制会被持续激活更长时间。最终，会造成不可逆转的损害，这会导致各种慢性疾病的功能受损和预后变差。慢性心力衰竭的标志性试验为神经激素拮抗剂的预后益处提供了有力证据。它们在慢性阻塞性肺疾病中有益作用的回顾性和流行病学数据开始积累，未来可能会在新的领域（如癌症和中风）得到应用。
