急性心力衰竭内科治疗的循证医学  

Evidence-based medicine in the treatment of acute heart failure

作　　者：韦丙奇[1] 张健[1] 

机构地区：[1]中国医学科学院阜外心血管病医院内科心衰监护病房,北京100037

出　　处：《临床药物治疗杂志》2012年第4期45-48,共4页Clinical Medication Journal

摘　　要：在急性心力衰竭的内科治疗措施中,无创呼吸支持和超滤等新技术的效果获得了循证医学的支持,无创呼吸支持可有效缓解急性心源性肺水肿患者的症状,降低气管插管和呼吸机的使用率,降低住院死亡率。超滤可有效缓解钠水潴留的相关症状,效果优于利尿药,不良事件两组相似。人重组脑钠肽和左西孟旦等新药的疗效和安全性也有了初步的循证医学证据。而传统药物如袢利尿药、吗啡、硝酸甘油等基本用药对急性心力衰竭预后的影响还缺乏循证医学的评价。需要开展相应的循证医学研究来进一步明确其对急性心力衰竭患者近期和远期预后的影响。In recent years, several new techniques and medicinces, such as noninvasive respiratory support （NIRS）, ultrafiltration, rhBNP and levosimendan, have been proved to be effective and safe in the treatment of acute heart failure （AHF） by evidence-based medicine. But, some traditional medicines, such as diuretics, morphine and nitroglycerin, are still not evaluated by evidence-based medicine. Evidence showed that, a successful use of NIV is associated with improved outcomes in patients with AHF; in hypervolemic AHF patients, ultrafiltration produces greater weight and fluid loss than intravenous diuretics, and was associated with significant reductions in the rate and length of rehospitalization and unscheduled medical visits for HF.

关 键 词：急性心力衰竭 利尿药 吗啡 人重组B型脑钠肽 超滤 

分 类 号：R541[医药卫生—心血管疾病] R972[医药卫生—内科学]