Liu Chao, Liu Kunshen
Heart Center, First Hospital of Hebei Medical University, Hebei University, Shijiazhuang, People's Republic of China.
J Card Fail. 2014 Sep;20(9):625-9. doi: 10.1016/j.cardfail.2014.06.353. Epub 2014 Jun 23.
Diuretic resistance in heart failure is defined as a state in which diuretic response is diminished or lost before the therapeutic goal of relief from congestion has been reached. Diuretic resistance is very common and is associated with poor outcomes. Over the past decade, several new drugs and devices targeting decongestion and improvement in renal function in patients with heart failure have failed to show benefit in randomized clinical trials. Glucocorticoids had been used to manage diuretic resistance before the advent of loop diuretics. More recent evidence appears to confirm that glucocorticoids may also help to overcome resistance to loop diuretics. This review tries to summarize the available evidence and potential mechanisms related to glucocorticoid therapy in patients with heart failure and its effect on diuretic resistance.
心力衰竭中的利尿剂抵抗被定义为一种状态，即在达到缓解充血的治疗目标之前，利尿剂反应减弱或丧失。利尿剂抵抗非常常见，且与不良预后相关。在过去十年中，几种针对心力衰竭患者减轻充血和改善肾功能的新药及装置在随机临床试验中均未显示出益处。在袢利尿剂出现之前，糖皮质激素就已被用于处理利尿剂抵抗。最近的证据似乎证实，糖皮质激素也可能有助于克服对袢利尿剂的抵抗。本综述试图总结与心力衰竭患者糖皮质激素治疗相关的现有证据、潜在机制及其对利尿剂抵抗的影响。
