醛固酮受体拮抗剂——心力衰竭药物治疗的新纪元  

Aldosterone receptor antagonist:a new drug therapy for heart failure

作　　者：戚玮琳[1] 李勇[1] 

机构地区：[1]复旦大学附属华山医院心内科,上海200040

出　　处：《世界临床药物》2011年第11期655-658,共4页World Clinical Drug

摘　　要：神经内分泌失调与慢性心力衰竭(CHF)的不良预后相关,是临床CHF治疗的一个重要靶点。心力衰竭患者虽已接受血管紧张素转化酶抑制剂(ACEI)或血管紧张素受体阻断剂(ARB)以及β受体阻断剂等治疗,但心血管事件发生率仍然很高。选择性醛固酮受体拮抗剂依普利酮与神经内分泌抑制剂联合应用,可降低轻度收缩性心力衰竭患者的死亡率和住院率,且与螺内酯相比,可更进一步减少长期治疗所致的内分泌紊乱。本文综述醛固酮拮抗剂治疗心衰的意义,重点介绍依普利酮在慢性收缩性心力衰竭治疗中的循证依据与优势。Neuroendocrine disorders are associated with poor outcomes of chronic heart failure（CHF）.It should be noted that although angiotensin-converting enzyme inhibitor（ACEI）,angiotensin receptor blocker（ARB）and β receptor blocker have been used for the therapy of CHF,the incidence of residual cardiovascular events remains high.As a selective aldosterone receptor blocker,eplerenone combined with other neurohormonal modulators such as ACEI can reduce both the risk of death and hospitalization in patients with systolic heart failure.Compared with spirolactone,eplerenone has benefit in reducing the risk of metabolic disorders caused by long-term therapy.This review describes the significance of aldosterone receptor antagonist against CHF and focuses on the clinical evidence and advantage of eplerenone.

关 键 词：神经内分泌失调 神经激素调节剂 慢性心力衰竭 醛固酮受体拮抗剂 依普利酮 

分 类 号：R972.1[医药卫生—药品] R541.6[医药卫生—药学]