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Lancet：心衰的现状

2017-05-07 MedSci MedSci原创

心衰治疗死亡
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心脏衰竭在成年人中的发病率很高，其发病率和死亡率在世界范围内的居高不下。尽管目前许多治疗方法可以改善心衰患者的心脏射血功能，如血管紧张素转换酶（ACE）抑制剂，血管紧张素受体阻断剂（ARBs），β受体阻滞剂和盐皮质激素受体拮抗剂，以及一些先进的装置疗法，但是，心衰的发病率仍然持续增长，这可能是由于人口老龄化以及对急性心血管事件的治疗的改进。与依那普利相比，联合血管紧张素受体阻断剂脑咖肽酶抑制剂（A

心脏衰竭在成年人中的发病率很高，其发病率和死亡率在世界范围内的居高不下。

尽管目前许多治疗方法可以改善心衰患者的心脏射血功能，如血管紧张素转换酶（ACE）抑制剂，血管紧张素受体阻断剂（ARBs），β受体阻滞剂和盐皮质激素受体拮抗剂，以及一些先进的装置疗法，但是，心衰的发病率仍然持续增长，这可能是由于人口老龄化以及对急性心血管事件的治疗的改进。

与依那普利相比，联合血管紧张素受体阻断剂脑咖肽酶抑制剂（ARNI）可以改善心脏衰竭患者的住院率和死亡率。目前的指南建议，在合适的患者中建议使用ARNI替代ACE抑制剂或ARB。

改善左心室的辅助装置越来越安全，这也意味着在更严重症状的患者中使用这些装置变得越来越普遍。

抗糖尿病的治疗可能进一步改善心力衰竭患者的疗效。

目前，在左心室射血分数降低的心力衰竭患者中正在研究具有新的作用机制的药物，例如心肌肌球蛋白激活剂。

具有保留射血分数的心力衰竭是一种尚未完全了解的异质性疾病，并且随着人口老龄化，患病率将继续增加。

尽管有些数据表明螺内酯可能会改善这些患者的结局，但目前没有治疗结果显示出其具有显着的效果。

希望未来的研究将解决心力衰竭患者的这些的需求。但迄今为止，急性心力衰竭患者的入院率继续增加，尚无新的疗法改善临床疗效。

原始出处：
Metra M, Teerlink JR. Heart failure. Lancet. 2017 Apr 28. pii: S0140-6736(17)31071-1. doi: 10.1016/S0140-6736(17)31071-1.

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2018-04-02 howi

    #Lancet#

    0

  2. 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    2017-05-10 nina1125

    心衰真是头疼啊

    0

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    2017-05-09 1ddf0692m34(暂无匿称)

    学习了，很好

    0

  4. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-08 孙文杰

    很新的研究，学习了

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-08 大爰

    研究的透彻学习并分享！

    0

  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-08 137****8002

    心衰的治疗仍需进一步探究

    0

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-07 杨利洪

    学习了，分享

    0

  8. 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    2017-05-07 1e13566dm72(暂无匿称)

    了解了心衰的进展，对治疗有帮助

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-07 (de84cd8m

    学习了

    0

  10. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:38:10 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-07 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

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