摘要
以往心力衰竭(心衰)神经激素拮抗治疗主要阻止交感神经系统(SNS)和肾素-血管紧张素-醛固酮系统(RAAS)两个系统的致病作用,降低心衰死亡风险。保护利钠肽系统(NPS)的血管紧张素受体脑啡肽酶抑制剂(ARNI)阻止利钠肽降解,进一步降低全因死亡风险16%,开启了3类系统神经激素拮抗剂治疗心衰的新时代。指南推荐射血分数下降的心衰(HFrEF)患者使用血管紧张素转化酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)或ARNI,联合β受体阻滞剂,部分患者合用醛固酮拮抗剂,减少心衰的发病率及病死率。
In past decades,neurohormone antagonists in heart failure mainly targeted SNS and RAAS to reduce the death and hospitalizations.Now a new angiotensin receptor enkephalin inhibitor(ARNI),targeting NPS,has been proved to inhibit the degradation of natriuretic peptides and further reduce the risk of all-cause mortality by 16%.It then opens a new era of therapy for heart failure:three types of neurohormone antagonists.The guidelines recommended that heart failure with reduced ejection fraction(HfrEF)patients use angiotensin converting enzyme inhibitors(ACEI)or angiotensin receptor blocker(ARB)or ARNI,combined withβblockers,and if necessary,aldosterone antagonists,to reduce the incidence and mortality of heart failure.
作者
廖梦阳
袁璟
廖玉华
LIAO Mengyang;YUAN Jing;LIAO Yuhua(Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology ,Key Laboratory of Biological Targeted Therapy of the Ministry of Education,Center of Cardiovascular Medical Control Quality of Hubei Province, Wuhan, 430022,China)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第7期583-585,共3页
Journal of Clinical Cardiology
