《中国透析患者慢性心力衰竭管理指南》解读  

Interpretation of Guidelines for the management of chronic heart failure in dialysis patients in China

作　　者：孙雪峰[1] SUN Xuefeng(Department of Nephrology,the First Medical Center of Chinese PLA General Hospital,State Key Laboratory of Kidney Diseases,National Clinical Research Center for Kidney Disease,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心、肾脏病医学部肾脏疾病国家重点实验室、慢性肾病国家临床医学研究中心,北京100853

出　　处：《中国实用内科杂志》2023年第3期210-217,230,共9页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金面上项目(92049103)。

摘　　要：《中国透析患者慢性心力衰竭管理指南》针对透析患者的心力衰竭诊断、危险因素管理、血液透析管理、腹膜透析管理、药物管理及其他管理等问题做了系统介绍。但是,笔者基于目前研究证据进行分析,认为该指南在N末端B型利钠肽前体评估、血管紧张素受体脑啡肽酶抑制剂疗效、降压治疗、贫血治疗、医疗器械治疗等方面存在问题。文章对此进行解读并提出推荐意见,以指导临床医生正确认识该指南,避免机械照搬执行,保障医疗安全。“Guidelines for the management of chronic heart failure in dialysis patients in China”systematically introduces the diagnosis of heart failure,management of risk factors,management of hemodialysis,management of peritoneal dialysis,management of drugs and other.However,this guideline has some problems with respect to evaluation of N-terminal pro-B type natriuretic peptide(NT-proBNP),efficacy of angiotensin receptor neprilysin inhibitor,antihypertensive and anemia treatment,treatment with medical devices,and other aspects.This paper interprets these issues based on current research evidence and puts forward recommentations,aiming to guide clinicians to correctly understand the guidelines and avoid stereoyped implementation in order to guarantee clinical safety.

关 键 词：透析 慢性心力衰竭 N末端B型利钠肽前体 血管紧张素受体脑啡肽酶抑制剂 指南 解读 

分 类 号：R692[医药卫生—泌尿科学]