Marenzi Giancarlo, Morpurgo Marco, Agostoni Piergiuseppe
Centro Cardiologico Monzino, I.R.C.C.S., Via Parea 4, 20138, Milan, Italy,
Am J Cardiovasc Drugs. 2015 Apr;15(2):103-12. doi: 10.1007/s40256-015-0107-6.
Most patients hospitalized for acutely decompensated heart failure (ADHF) present with symptoms and signs of volume overload, which are also associated with high rates of death and re-hospitalization. Several studies have investigated the possible use of extracorporeal ultrafiltration in the management of ADHF, evaluating potential clinical benefits in terms of hospitalization and survival rates versus those of conventional diuretic therapy. Though ultrafiltration remains an extremely appealing therapeutic option for patients with AHDF, some of the most recent studies have reported conflicting results. Differences in the selection of study population, heterogeneity of the indications for the use of ultrafiltration, disparity in the ultrafiltration protocols, and high variability in the pharmacologic therapies used for the control group could explain some of these contradictory findings. The purpose of the present review is to provide an overview and an update on the mechanisms and clinical effects of ultrafiltration and on currently available evidence supporting its use in ADHF.
大多数因急性失代偿性心力衰竭（ADHF）住院的患者表现出容量超负荷的症状和体征，这也与高死亡率和再住院率相关。多项研究探讨了体外超滤在ADHF管理中的可能应用，评估了与传统利尿剂治疗相比，在住院率和生存率方面的潜在临床益处。尽管超滤对AHDF患者仍然是一种极具吸引力的治疗选择，但一些最新研究报告了相互矛盾的结果。研究人群选择的差异、超滤使用指征的异质性、超滤方案的差异以及对照组所用药物治疗的高度变异性，可能解释了其中一些相互矛盾的发现。本综述的目的是概述和更新超滤的机制、临床效果以及支持其在ADHF中应用的现有证据。
