[根据现行指南,利尿剂在心力衰竭治疗中的地位]。

Przeglad lekarski Pub Date : 2016-01-01
Krzysztof Bury, Jadwiga Nessler
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引用次数: 0

摘要

利尿剂是继地高辛之后治疗心力衰竭使用时间最长的药物。这是由于它们对钠潴留的影响和心衰发生时继发于神经激素和血流动力学障碍的细胞外空间液体体积的增加,以及它们在治疗症状性心衰方面的有效性。停用利尿剂或使用利尿剂剂量过小是导致心衰加重或急性心衰的原因之一。大多数利尿剂的有效性并没有在临床试验中得到证实,它们的使用适应症通常只是基于专家的意见。这些药物对心衰患者发病率和死亡率的影响未被检查。利尿剂可减轻气短和肿胀。因此,无论左心室射血分数如何,建议有液体潴留症状和体征的患者使用本品。
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[Position of diuretics in the treatment of heart failure in light of current guidelines].

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.

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