正性肌力药物治疗心力衰竭新进展

New Progress of Positive Inotropic Drugs in the Treatment of Heart Failure

摘要: 心力衰竭是心脏疾病发展的终末阶段，尽管目前器械治疗及生物疗法日新月异，正性肌力药在心衰治疗中仍处于重要地位，其通过增加心脏输出量、降低心室充盈压，改善外周灌注的方式保证重要器官的血液供应。但研究表明正性肌力药物的不良反应可能导致患者病情恶化，增加死亡风险。近年来，几款新型正性肌力药物的面世为临床用药提供更多选择，本文将从作用机制、临床效果、研究现状及指南推荐等方面，就传统正性肌力药物，如洋地黄、儿茶酚胺类等，以及新型正性肌力类药物，如钙离子增敏剂、omecamtiv mecarbil等药物作一综述。

Abstract: Heart failure is the final stage of the development of heart disease. Although the device treatment and biological therapy are changing with each passing day, positive inotropic drugs are still in an important position in the treatment of heart failure. They ensure the blood supply of important or-gans by increasing cardiac output, reducing ventricular filling pressure and improving peripheral perfusion. However, studies have shown that the adverse reactions of positive inotropic drugs may lead to the deterioration of patients’ condition and increase the risk of death. In recent years, the emergence of several new positive inotropic drugs provides more choices for clinical medication. This paper will review the traditional positive inotropic drugs, such as digitalis and catecholamines, as well as new positive inotropic drugs, such as calcium sensitizer, omecamtiv mecarbil and so on.