针对晚期心力衰竭患者应规范使用正性肌力药物——《欧洲心脏病学会心力衰竭协会临床专家共识》解读  

Interpretation of“Inotropic Therapy in Patients With Advanced Heart Failure.A Clinical Consensus Statement From the Heart Failure Association of the European Society of Cardiology”

作　　者：陈牧雷[1] 董蔚[2] 李广平[3] 王欣[1] 杨杰孚[4] 张健[5] CHEN Mulei;DONG Wei;LI Guangping;WANG Xin;YANG Jiefu;ZHANG Jian(Department of Cardiology,Capital Medical University and Beijing Chaoyang Hospital,Beijing 100020,China;Department of Cardiology,Chinese PLA General Hospital,Beijing 100853,China;Department of Cardiology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Cardiology,Beijing Hospital,Beijing 100005,China;Department of Cardiology,National Center for Cardiovascular Disease and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]首都医科大学附属北京朝阳医院心内科,北京100020 [2]中国人民解放军总医院心内科,北京100853 [3]天津医科大学第二医院心内科,天津300211 [4]北京医院心内科,北京100005 [5]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京100037

出　　处：《中国循环杂志》2023年第8期882-886,共5页Chinese Circulation Journal

摘　　要：2023年2月欧洲心脏病学会心力衰竭协会发布《晚期心力衰竭患者中正性肌力药物的应用:欧洲心脏病学会心力衰竭协会临床专家共识》。以往国内外心力衰竭指南建议,应在有器官灌注不良或休克证据的急性失代偿心力衰竭患者中使用正性肌力药物。而这版临床专家共识指出,在一些没有急性严重失代偿的晚期慢性心力衰竭患者中,应用正性肌力药物(如多巴胺、多巴酚丁胺、米力农和左西孟旦等)可能也是合理的,这为正性肌力药物的使用开辟了新的适应人群,也对临床医生合理规范使用正性肌力药物提出更高要求。目前,我国临床工作者对正性肌力药物在晚期心力衰竭的使用仍存在困惑,且不规范用药的情况也时有发生。为帮助我国广大临床医生更好的理解此版专家共识,合理、规范的使用正性肌力药类药物,结合我国国情及临床实践,对此版专家共识进行解读。In February 2023,the European Journal of Heart Failure released the"Inotropic therapy in patients with advanced heart failure.A clinical consensus statement from the Heart Failure Association of the European Society of Cardiology".Prior this statement,both domestic and international guidelines for heart failure suggest the use of inotropic drugs in patients with acute decompensated heart failure who have evidence of organ hypoperfusion or shock.This version of clinical expert consensus points out that in some patients with advanced chronic heart failure without acute severe decompensation,the use of inotropic drugs(such as dopamine,dobutamine,milrinone and Levosimendan)may also be reasonable.It thus expands patient population for the potential use of inotropic drugs,and also puts forward higher requirements for clinicians to use inotropic drugs reasonably and normatively.At present,clinicians in China still have confusions about the use of inotropic drugs in late stage heart failure patients,and there are also cases of non-standard medication in these patient population.In order to help clinicians in China better understand this version of the expert consensus and use inotropic drugs in a reasonable and standardized manner,the editorial committee of the Chinese Circulation Journal organized experts to interpret this version of the expert consensus based on relevant guidelines and combined with China's national conditions and clinical practice.

关 键 词：正性肌力药物 晚期心力衰竭 专家共识 

分 类 号：R54[医药卫生—心血管疾病]