天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (4): 347-352.doi: 10.11958/20193347

• 综述 • 上一篇    

心力衰竭患者利尿剂抵抗的研究进展 #br#

王丹妮 1，2，冯津萍 3△，冯超 3，陈树涛 3
  

  1. 1天津医科大学胸科临床学院（邮编 300222）；2天津医科大学研究生院；3天津市胸科医院 CICU
  • 收稿日期:2019-11-05 修回日期:2020-01-15 出版日期:2020-04-15 发布日期:2020-06-23
  • 通讯作者: 冯津萍 E-mail:chlfjp@sina.com
  • 作者简介:王丹妮（1993），女，硕士在读，主要从事冠心病与心力衰竭的研究
  • 基金资助:
    心脏康复与代谢治疗研究基金资助项目（CCA-CRMT-1805）

Research advances in diuretic resistance in patients with heart failure #br#

WANG Dan-ni1,2, FENG Jin-ping3△, FENG Chao3, CHEN Shu-tao3 #br#   

  1. 1 Thoracic Clinical College, Tianjin Medical University, Tianjin 300222, China; 2 Graduate School of Medicine, Tianjin
    Medical University; 3 Department of CICU, Tianjin Chest Hospital
  • Received:2019-11-05 Revised:2020-01-15 Published:2020-04-15 Online:2020-06-23
  • Contact: FENG Jin-ping E-mail:chlfjp@sina.com

PDF (PC)

3783

摘要： 心力衰竭是各种心脏疾病发展的终末阶段，近年来我国心衰患病率逐渐升高，正在成为 21世纪最重要的
心血管病症。心力衰竭的药物治疗主要包括两个方面，一是延缓疾病进展，主要包括内啡肽酶抑制剂（沙库巴曲缬
沙坦）、血管紧张素转化酶抑制剂（ACEI）、血管紧张素Ⅱ受体拮抗剂（ARB）、β受体阻断剂、醛固酮受体拮抗剂等药
物；二是改善症状如呼吸困难、水肿等，主要包括利尿剂、血管扩张剂等。考虑到充血在心力衰竭中的关键作用，利
尿剂是心力衰竭治疗的基石，然而临床上由于各种原因，导致 20%~30%患者产生利尿剂抵抗，使心衰患者的治疗效
果明显降低。本文就利尿剂抵抗的定义、发病机制及其治疗策略进行综述。

关键词: 心力衰竭, 利尿药, 渗透性, 利尿剂抵抗

Abstract: Heart failure is the final stage of the development of various heart diseases. In recent years, the prevalence of
heart failure in China has gradually increased and is becoming the most important cardiovascular disease in the 21 st
century. Diuretics are the key and basis for the treatment of heart failure. The drug treatment of heart failure mainly includes two aspects, one is to delay the progress of the disease, mainly including endorphin inhibitor (sakutravalsartan), angiotensin converting enzyme inhibitor (ACEI), angiotensin II receptor antagonist (ARB), beta blocker, aldosterone receptor antagonist and other drugs; the other is to improve symptoms such as dyspnea and edema, including diuretics and vasodilators. Considering the key role of congestion in heart failure, diuretics are the cornerstone of heart failure treatment. However, due to various reasons, 25% -30% of the patients have diuretic resistance, which significantly reduces the therapeutic effect in patients with heart failure. This article reviews the definition, pathogenesis and therapeutic strategy of diuretic resistance.

Key words: heart failure, diuretics,osmotic, diuretic resistance

中图分类号: