慢性充血性心力衰竭中利尿剂抵抗的观点
A perspective on diuretic resistance in chronic congestive heart failure.
作者信息
Shah Niel, Madanieh Raef, Alkan Mehmet, Dogar Muhammad U, Kosmas Constantine E, Vittorio Timothy J
机构信息
St. Francis Hospital, The Heart Center ®, Center for Advanced Cardiac Therapeutics, Roslyn, NY, USA.
Brown University, College of Arts and Sciences, Providence, RI, USA.
出版信息
Ther Adv Cardiovasc Dis. 2017 Oct;11(10):271-278. doi: 10.1177/1753944717718717. Epub 2017 Jul 20.
Abstract
Chronic congestive heart failure (CHF) is a complex disorder characterized by inability of the heart to keep up the demands on it, followed by the progressive pump failure and fluid accumulation. Although the loop diuretics are widely used in heart failure (HF) patients, both pharmacodynamic and pharmacokinetic alterations are thought to be responsible for diuretic resistance in these patients. Strategies to overcome diuretic resistance include sodium intake restriction, changes in diuretic dose and route of administration and sequential nephron diuretic therapy. In this review, we discuss the definition, prevalence, mechanism of development and management strategies of diuretic resistance in HF patients.
摘要
慢性充血性心力衰竭（CHF）是一种复杂的病症，其特征为心脏无法满足身体对其的需求，继而出现进行性泵功能衰竭和液体潴留。尽管袢利尿剂广泛应用于心力衰竭（HF）患者，但药效学和药代动力学改变均被认为是导致这些患者出现利尿剂抵抗的原因。克服利尿剂抵抗的策略包括限制钠摄入、改变利尿剂剂量和给药途径以及序贯肾单位利尿剂治疗。在本综述中，我们讨论了HF患者利尿剂抵抗的定义、患病率、发生机制和管理策略。
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