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摘要: 心力衰竭(心衰)为各种心血管疾病的终末阶段,在中国人群中的患病率约为1.3%,随着年龄的增长而骤增,其中心衰伴肾功能不全患者占据了慢性心衰患者的40%。尽管目前临床拥有多种药物治疗方案,但仍然不能显著改善心衰患者的预后,特别是在合并肾功能不全患者中。因此亟需研发新型治疗药物。沙库巴曲/缬沙坦、钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂、维利西呱作为近年来心衰治疗领域的新型药物,从不同机制改善心衰患者临床症状,降低心衰住院率与死亡风险,并且对肾功能的改善(降低血肌酐水平、延缓肾小球滤过率下降、降低尿白蛋白与肌酐比值等)有着独特的作用。沙库巴曲/缬沙坦和SGLT-2抑制剂的使用在心衰治疗中具有里程碑式的意义,维利西呱作为新型抗心衰口服药物在心肾方面也展现出积极的作用,这些药物的规范临床应用可以使更多的心衰患者从中获益。Abstract: Heart failure is the terminal stage of various cardiovascular diseases. The prevalence of heart failure in the Chinese population is about 1.3%, and increases sharply with age, among which the patients with heart failure and renal insufficiency account for 40%. Despite the availability of multiple therapeutic regimens, the prognosis of patients with heart failure has not been significantly improved, especially in patients with chronic kidney disease. Therefore, there is an urgent need to develop new therapeutic drugs. As new drugs in heart failure treatment in recent years, sacubitril/valsartan, SGLT-2 inhibitors, and vericiguat can improve the clinical symptoms of patients with heart failure with different mechanisms and reduce the heart failure hospitalization, and death risk. Moreover, they have unique effects on improving renal function(reducing serum creatinine level, delaying the decrease of glomerular filtration rate, reducing the urinary albumin: creatinine ratio, etc.). The use of sacubitril/valsartan and SGLT-2 inhibitors has been a milestone in treating heart failure. Vericiguat has also shown positive effects on the heart and kidney as a new oral drug for heart failure. The standard clinical use of these drugs could benefit more patients with heart failure.
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Key words:
- heart failure,chronic /
- chronic kidney disease /
- sacubitril/valsartan /
- SGLT-2 inhibitors /
- vericiguat
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