心力衰竭患者利尿剂抵抗诊断及管理中国专家共识
Chinese expert consensus for the diagnosis and management of diuretic resistance in patients with heart failure
中国医师协会心血管内科分会 中国老年医学学会心电及心功能分会 中国心衰中心联盟专家委员会 杨杰孚 廖玉华 董蔚
摘要
利尿剂是住院心力衰竭(heart failure,HF)特别是急性失代偿心力衰竭(acute decompensated heart failure,ADHF)患者容量管理的基石.利尿剂抵抗(diuretic resistance,DR)表现为对利尿剂的反应减低甚至完全失效,不仅导致住院时间延长,还使病死率和再住院率增加.目前国内外尚缺乏对HF患者DR诊断和管理的共识.本共识梳理DR的定义、机制、诊断和管理等方面内容,并基于临床研究结果和专家经验,提出相应的处理建议,旨在提高临床医师对DR的认识,并规范DR治疗.
Abstract
Diuretics play a crucial role in volume management for hospitalized patients with heart failure(HF),particularly those with acute decompensated HF(ADHF).Diuretic resistance(DR),manifested as a di-minished response or even a failure to diuretics,which not only prolongs in-hospital stay but also increases mortal-ity and rehospitalization.There is not yet a consensus regarding the diagnosis and management of DR in heart fail-ure patients.Therefore,this consensus focuses on elucidating the definition,mechanisms,diagnosis,and man-agement of DR.Based on clinical research findings and expert experiences,it offers recommendations for treat-ment,aiming to enhance physicians'awareness and standardize the management.
关键词
心力衰竭/利尿剂抵抗/容量管理Key words
heart failure/diuretic resistance/volume management引用本文复制引用
基金项目
北京市自然科学基金-海淀原始创新联合基金(L222006)
出版年
2024
NETL
NSTL
万方数据