肝心轴在急性心衰利尿剂抵抗中的研究进展

Research Progress on the Hepato-Cardio-Axial Axis in Diuretic Resistance of Acute Heart Failure

摘要: 急性心力衰竭患者大部分存在液体超负荷，这种严重的容量超负荷状态会进一步恶化心脏功能，增加心肌耗氧，并可能导致器官灌注受损。因此，迅速、有效地解除充血是首要目标。然而在心力衰竭各阶段,利尿剂反应均受到利尿剂抵抗和利尿效率低下的挑战，利尿剂抵抗作为急性心力衰竭患者恶化和死亡的独立危险因素逐渐受到关注，传统机制多聚焦于肾脏本身，而肝心轴即心脏与肝脏间的病理生理双向对话，为理解该难题提供了全新视角。本文将对肝心轴在急性心力衰竭患者利尿剂抵抗中的作用机制与研究进展作一综述。

Abstract: Most patients with acute heart failure have fluid overload. This severe volume overload state further deteriorates cardiac function, increases myocardial oxygen consumption, and may lead to impaired organ perfusion. Therefore, rapid and effective decongestion is the primary goal. However, at all stages of heart failure, diuretic response is challenged by diuretic resistance and low diuretic efficiency. Diuretic resistance, as an independent risk factor for deterioration and death in patients with acute heart failure, has gradually attracted attention. Traditional mechanisms mostly focus on the kidneys themselves, while the hepato-cardiac-axis, the bidirectional pathological and physiological dialogue between the heart and liver, provides a new perspective for understanding this problem. This article will review the mechanism and research progress of the hepato-cardiac-axis in diuretic resistance in patients with acute heart failure.