射血分数降低性心力衰竭的药物治疗进展

Advances in Pharmacologic Treatment of Heart Failure with Reduced Ejection Fraction

摘要: 心力衰竭(HF)是一种常见的疾病，尽管近年来治疗有所改善，但射血分数降低性心力衰竭(HFrEF)仍然是导致患者死亡和低水平生活质量增加的主要原因。随着抗心衰药物研究的不断发展，不少新药被广泛的运用到了心衰患者的治疗当中，其中血管紧张素受体脑啡肽酶抑制剂不仅能够改善患者的射血分数，降低死亡风险，已成为了目前国内外治疗心衰指南推荐的药物。对于心衰患者而言，血管紧张素受体脑啡肽酶抑制剂不仅耐受性高，而且能帮助患者维持血流动力学稳定。此外，钠–葡萄糖协同转运蛋白2抑制剂也具有同样的治疗效果，能够增强患者葡萄糖与钠经尿液排泄，降低患者的死亡风险，缩短住院治疗时间，同时其他的抗心衰药物的研究也取得了良好的成效。基于此，本文对新型药物的特点、作用机制及其安全性和耐受性的相关研究进行综述。希望为临床心衰患者的治疗提供帮助。

Abstract: Heart failure is a common disease. Although treatment has improved in recent years, heart failure with reduced ejection fraction remains increasing factor for mortality and morbidity. With the continuous development of anti-heart failure drug research, many new drugs have been widely used in the treatment of patients with heart failure. Among them, angiotensin receptor enkephalinase inhibitors can not only improve the ejection fraction and reduce the risk of death of patients, but also shorten the hospitalization time and promote the early recovery of patients, which have become the drugs recommended by the treatment guidelines for heart failure at home and abroad. For patients with heart failure, angiotensin receptor enkephalinase inhibitors not only have high safety, but also can help patients maintain hemodynamic stability. In addition, sodium-glucose cotransporter 2 inhibitors have the same therapeutic effect, which can enhance the excretion of glucose and sodium in urine, reduce the risk of death and shorten the hospitalization time. Meanwhile, other anti-heart failure drugs have also achieved good results. Based on this, this paper reviews the characteristics, mechanism, safety and tolerability of the new drugs, hoping to provide help for the clinical treatment of patients with heart failure.