心力衰竭诊断与药物治疗的研究进展  

Research progress in diagnosis and drug treatment of heart failure

作　　者：赵跃华 孟小敏[1] 李向欣[1] 张蒙蒙 王占启[1] ZHAO Yuehua;MENG Xiaoming;LI Xiangxin;ZHANG Mengmeng;WANG Zhanqi(Affiliated Hospital of Hebei University,Baoding,Hebei,071002,China;The First Affiliated Hospital of Hebei North University)

机构地区：[1]河北大学附属医院,河北保定071002 [2]河北北方学院第一附属医院

出　　处：《临床心血管病杂志》2020年第4期382-386,共5页Journal of Clinical Cardiology

基　　金：保定市科技计划项目(No:17ZF194);河北省老年病防治经费资助项目(No:361007)。

摘　　要：近年来,心力衰竭(HF)在器械设备治疗方面取得了显著进展,在药物治疗方面直到2019年才取得突破性的进展。其中,多项研究证实血管紧张素Ⅱ受体/脑啡肽酶抑制剂(ARNI)联合制剂———沙库巴曲缬沙坦是治疗HFrEF的有效药物;同时,大量RCT研究数据表明钠-葡萄糖共转运蛋白-2抑制剂(SGLT-2)具有心脏保护作用。尽管在HFpEF方面的研究进展缓慢,但研究显示ARNI和SGLT-2抑制剂有望成为其突破口。此外,2019年ESC对HFpEF的诊断提出了新的算法,有助于其在临床中寻找到有效的治疗方法。本综述对HFrEF和HFpEF在诊断和药物治疗方面的最新进展进行了相关总结,为临床提供参考。In recent years,significant progress has been made in the treatment of heart failure by instruments and equipment.Until the annual meeting of ESC in 2019,the results of many trials on drug therapy for heart failure have made great progress.Among them,the combined preparation of angiotensinⅡreceptor/enkephalin inhibitor(ARNI)has been proved to be an effective drug for the treatment of heart failure with reduced ejection fraction.At the same time,a large number of RCT data showed the cardioprotective effect of sodium-glucose co-transporter-2 inhibitor(SGLT-2).The two drugs were recommended of the European Heart Disease Society(ESC)guidelines for the diagnosis and treatment of heart failure.Although the research progress of HFpEF is slow,the research shows that ARNI and SGLT-2inhibitors are expected to be breakthroughs.In addition,the meeting proposed a new algorithm for the diagnosis of HFpEF,which is helpful to find an effective treatment in clinic.In this review,the latest progress of HFrEF and HFpEF in the diagnosis and treatment of drugs is summarized,and the reference for clinical application is provided.

关 键 词：心力衰竭 血管紧张素Ⅱ受体/脑啡肽酶抑制剂 钠-葡萄糖共转运蛋白-2抑制剂 

分 类 号：R541.6[医药卫生—心血管疾病]