醛固酮受体拮抗剂治疗慢性心力衰竭  

Aldosterone Receptor Antagonists in the Treatment of Chronic Heart Failure

作　　者：刘柏年[1] 殷雅琴[1] 

机构地区：[1]天津市胸科医院心内六科,天津300051

出　　处：《医学综述》2008年第13期2030-2033,共4页Medical Recapitulate

基　　金：天津市卫生局科技基金资助项目(04KI67)

摘　　要：肾素-血管紧张素-醛固酮系统在慢性心力衰竭(CHF)的发生、发展过程中起了关键性的作用。RALES试验及EPHESUS试验分别证实了醛固酮受体拮抗剂(ARA)对于慢性重度心力衰竭及急性心肌梗死后心力衰竭患者的治疗作用。目前,ARA已成为第3类有循证医学证据的治疗心力衰竭的有效药物。ARA治疗CHF的机制可能包括减轻心肌纤维化及改善心脏重塑、预防心源性猝死的发生及改善内皮功能等。使用ARA,一定要注意病例的选择。不良反应主要有高钾血症及性激素样反应,服用ARA者应定期监测血钾及肾功能。The rennin-angiotensin-aldasterone system plays critical role in the genesis and development of chronic heart failure. RALES and EPHESUE trials confirmed the therapeutic effects of aldosterone receptor antagonists on patients with severe heart failure and heart failure after acute myocardial infarction. At present, ARA have been the third medication with evidence-based medicine. The proposed mechanisms of action of ARA are inhibiting myocardial fibrosis and improving cardiac remodeling, preventing sudden cardiac death, improving endothelial functions and so on, The cases should be selected restrictly when ARA will be used, The main adverse effects are hyperkalemia and gynaecomastia, Serum potassium and renal function should be monitored regularly for the patients taking ARA.

关 键 词：醛固酮受体拮抗剂 慢性心力衰竭 心脏重塑 

分 类 号：R972[医药卫生—药品] R541.6[医药卫生—药学]