Bury Krzysztof, Nessler Jadwiga
Przegl Lek. 2016;73(6):424-9.
Diuretics are the longest-used drugs in heart failure after digoxin. This is due to their effect on the retention of sodium and an increase in the volume of fluid in the extracellular space secondary to neurohormonal and hemodynamic disorders occurs in heart failure, and their effectiveness in the treatment of symptomatic heart failure. Discontinuation of treatment with diuretics or use them in too small doses is one of the causes of exacerbation or acute heart failure.The effectiveness of most of diuretics does not confirm in the clinical trials, and the indications for their use are often based only on expert opinion. The effect of these drugs on morbidity and mortality in patients with HF was not examined. Diuretics reduce shortness of breath and swelling. For this reasons it is recom-mended to use them in patients with signs and symptoms of fluid retention regardless of the left ventricular ejection fraction.
利尿剂是继地高辛之后在心力衰竭治疗中使用时间最长的药物。这是由于它们对钠潴留的作用，以及心力衰竭时继发于神经激素和血流动力学紊乱的细胞外液量增加，还有它们在治疗有症状心力衰竭方面的有效性。停用利尿剂或使用剂量过小是病情加重或急性心力衰竭的原因之一。大多数利尿剂的有效性在临床试验中并未得到证实，其使用指征往往仅基于专家意见。这些药物对心力衰竭患者发病率和死亡率的影响尚未得到研究。利尿剂可减轻气短和水肿。因此，无论左心室射血分数如何，建议在有液体潴留体征和症状的患者中使用利尿剂。
