1型心肾综合征治疗进展
Progress in Treatment of Cardiorenal Syndrome Type 1
DOI: 10.12677/ACM.2022.12101318, PDF,   
作者: 吴晓庆, 马粜娟：西安医学院，陕西 西安；王晓明*：陕西省人民医院肾病血透中心，陕西 西安
关键词: 1型心肾综合征；发病机制；治疗；Cardiorenal Syndrome Type 1； Pathogenesis； Treatment
摘要: 1型心肾综合征(CRS-1)是指由急性心功能不全引起的急性肾损伤，是CRS的常见类型。CRS-1常导致患者住院日延长，病死率和复发率增高。因此，临床上对CRS-1的早期识别和及时治疗极其重要，但其病理生理学机制及治疗方法较为复杂多样。本文就CRS-1的发病机制及治疗策略作一综述，为缓解其临床症状，改善患者预后提供一些新思路。
Abstract: Cardiorenal syndrome type 1 (CRS-1) refers to acute renal injury caused by acute cardiac insuffi-ciency, which is the result of CRS common types. CRS-1 often leads to prolonged hospitalization, in-creased mortality and readmission. Therefore, clinical response to CRS-1 early identification and timely treatment are extremely important, but its pathophysiological mechanism and treatment methods are complicated. This article is about CRS-1 to summarize the pathogenesis and treatment strategies of the disease, in order to provide some new ideas to alleviate the clinical symptoms and improve the prognosis of patients.
文章引用：吴晓庆, 马粜娟, 王晓明. 1型心肾综合征治疗进展[J]. 临床医学进展, 2022, 12(10): 9117-9124. https://doi.org/10.12677/ACM.2022.12101318

参考文献

[1] Ronco, C., Haapio, M., House, A.A., et al. (2008) Cardiorenal Syndrome. Journal of the American College of Cardiolo-gy, 52, 1527-1539. [Google Scholar] [CrossRef] [PubMed]
[2] Ronco, C., McCullough, P., Anker, S.D., et al. (2010) Cardio-Renal Syndromes: Report from the Consensus Conference of the Acute Dialysis Quality Initiative. Euro-pean Heart Journal, 31, 703-711. [Google Scholar] [CrossRef] [PubMed]
[3] Harjola, V.P., Mullens, W., Banaszewski, M., et al. (2017) Organ Dysfunction, Injury and Failure in Acute Heart Failure: From Pathophysiology to Diagnosis and Management. A Review on Behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Car-diology (ESC). European Journal of Heart Failure, 19, 821-836. [Google Scholar] [CrossRef] [PubMed]
[4] Cheema, B., Ambrosy, A.P., Kaplan, R.M., et al. (2018) Lessons Learned in Acute Heart Failure. European Journal of Heart Failure, 20, 630-641. [Google Scholar] [CrossRef] [PubMed]
[5] Palazzuoli, A., Ruocco, G. (2018) Heart-Kidney Interactions in Cardiorenal Syndrome Type 1. Advances in Chronic Kidney Disease, 25, 408-417. [Google Scholar] [CrossRef] [PubMed]
[6] 陈志华. 中心静脉压水平与I型心肾综合征临床及预后的相关性[J]. 浙江临床医学, 2019, 21(7): 965.
[7] Palazzuoli, A., Ruocco, G., Pellicori, P., et al. (2019) The Prognostic Role of Different Renal Function Phenotypes in Patients with Acute Heart Failure. International Journal of Cardiology, 276, 198-203. [Google Scholar] [CrossRef] [PubMed]
[8] Volpe, M., Carnovali, M., Mastromarino, V. (2015) The Natriu-retic Peptides System in the Pathophysiology of Heart Failure: From Molecular Basis to Treatment. Clinical Science, 130, 57-77. [Google Scholar] [CrossRef] 
[9] Cody, R.J., Atlas, S.A., Laragh, J.H., et al. (1986) Atrial Natriu-retic Factor in Normal Subjects and Heart Failure Patients. Plasma Levels and Renal, Hormonal, and Hemodynamic Re-sponses to Peptide Infusion. Journal of Clinical Investigation, 78, 1362-1374. [Google Scholar] [CrossRef] 
[10] 王蕾, 王梓, 袁玲, 等. 参附强心丸调控肾素原受体介导MAPK信号通路抑制心肾细胞凋亡[J]. 中国实验方剂学杂志, 2016, 22(3): 121-126. [Google Scholar] [CrossRef] 
[11] 杨瑶, 徐萍, 石月萍, 等. 四逆汤抑制RhoA/ROCK信号通路改善大鼠心肌纤维化[J]. 中成药, 2017(7): 1342-1347. [Google Scholar] [CrossRef] 
[12] 何砚如, 陈立娟, 马根山. Notch信号通路对缺血心肌的保护作用[J]. 东南大学学报, 2016, 35(1): 139-143. [Google Scholar] [CrossRef] 
[13] Linhart, C., Ulrich, C., Greinert, D., et al. (2018) Sys-temic Inflammation in Acute Cardiorenal Syndrome: An Observational Pilot Study. ESC Heart Failure, 5, 920-930. [Google Scholar] [CrossRef] [PubMed]
[14] Virzì, G.M., Breglia, A., Castellani, C., et al. (2019) Lipopolysaccharide in Systemic Circulation Induces Activation of Inflammatory Response and Oxidative Stress in Cardiorenal Syndrome Type 1. Journal of Nephrology, 32, 803-810. [Google Scholar] [CrossRef] [PubMed]
[15] 徐潇漪, 孙丽君, 程虹, 等. 补体活化在原发性恶性高血压合并严重心肾损伤中的作用[J]. 中华肾脏病杂志, 2022, 38(2): 115-125. [Google Scholar] [CrossRef] 
[16] Kuro-o, M. (2012) Klotho in Health and Disease. Current Opinion in Nephrology and Hypertension, 21, 362-368. [Google Scholar] [CrossRef] 
[17] Sarafidis, P., Ferro, C.J., Morales, E., et al. (2019) SGLT-2 Inhibitors and GLP-1 Receptor Agonists for Nephroprotection and Cardioprotection in Patients with Diabetes Mellitus and Chronic Kidney Disease. A Consensus Statement by the EURECA-m and the DIABESITY Working Groups of the ERA-EDTA. Nephrology Dialysis Transplantation, 34, 208-230. [Google Scholar] [CrossRef] [PubMed]
[18] Rangaswami, J., Bhalia, V., de Boer, I.H., et al. (2020) Cardiorenal Protec-tion with the Newer Antidiabetic Agents in Patients with Diabetes and Chronic Kidney Disease: A Scientific Statement from the American Heart Association. Circulation, 142, e265-e286. [Google Scholar] [CrossRef] 
[19] Navarro-González, J., Ferri, C., Martín-Núez, E., et al. (2020) P1008 Therapy with Sodium-Glucose Cotransporter Type 2 Inhibitors Increases Klotho in Type 2 Diabetic Pa-tients. Nephrology Dialysis Transplantation, 35, 1008. [Google Scholar] [CrossRef] 
[20] Sharma, K., Vaishnav, J., Kalathiya, R., et al. (2018) Randomized Evaluation of Heart Failure with Preserved Ejection Fraction Patients with Acute Heart Failure and Dopamine. JACC: Heart Failure, 6, 859-870. [Google Scholar] [CrossRef] [PubMed]
[21] Felker, G.M., Lee, K.L., Bull, D.A., et al. (2011) Diuretic Strategies in Patients with Acute Decompensated Heart Failure. New England Journal of Medicine, 364, 797-805. [Google Scholar] [CrossRef] 
[22] 王旭辉, 周兴其. 托伐普坦对ADHF合并轻中度肾功能损伤患者利尿效果及电解质指标的影响[J]. 浙江创伤外科, 2022, 27(1): 125-127. [Google Scholar] [CrossRef] 
[23] 何晓全, 高翔宇, 周力, 等. 托伐普坦联合重组人脑利钠肽在老年患者急性左心衰竭合并急性心肾综合征中的有效性[J]. 临床心血管病杂志, 2021, 37(12): 1137-1141. [Google Scholar] [CrossRef] 
[24] Takayuki, I., Yuki, I., Keisuke, K., et al. (2018) Effects of Additive Tolvaptan vs. Increased Furosemide on Heart Failure with Diuretic Resistance and Renal Im-pairment—Results from the K-STAR Study. Circulation Journal, 82, 159-167. [Google Scholar] [CrossRef] 
[25] Vaduganathan, M., Gheorghiade, M., Pang, P.S., et al. (2012) Effi-cacy of Oral Tolvaptan in Acute Heart Failure Patients with Hypotension and Renal Impairment. Journal of Cardiovas-cular Medicine, 13, 415-422. [Google Scholar] [CrossRef] 
[26] Kimura, K., Momose, T., Hasegawa, T., et al. (2016) Early Administration of Tolvaptan Preserves Renal Function in Elderly Patients with Acute Decompensated Heart Failure. Journal of Cardiology, 67, 399-405. [Google Scholar] [CrossRef] [PubMed]
[27] Theresa, A.M., Marco, M., Marianna, A., et al. (2021) 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. European Heart Journal, 42, 3599-3726. [Google Scholar] [CrossRef] [PubMed]
[28] Zima, E., Farmakis, D., Pollesello, P., et al. (2020) Dif-ferential Effects of Inotropes and Inodilators on Renal Function in Acute Cardiac Care. European Heart Journal Supple-ments, 22, D12-D19. [Google Scholar] [CrossRef] [PubMed]
[29] Giamouzis, G., Butler, J., Starling, R.C., et al. (2010) Impact of Dopamine Infusion on Renal Function in Hospitalized Heart Failure Patients: Results of the Dopamine in Acute Decompensated Heart Failure (DAD-HF) Trial. Journal of Cardiac Failure, 16, 922-930. [Google Scholar] [CrossRef] [PubMed]
[30] Triposkiadis, F.K., Butler, J., Karayannis, G., et al. (2014) Effi-cacy and Safety of High Dose versus Low Dose Furosemide with or without Dopamine Infusion: The Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) Trial. International Journal of Cardiology, 172, 115-121. [Google Scholar] [CrossRef] [PubMed]
[31] Fedele, F., Bruno, N., Brasolin, B., et al. (2014) Levosimendan Improves Renal Function in Acute Decompensated Heart Failure: Possible Underlying Mechanisms. European Journal of Heart Failure, 16, 281-288. [Google Scholar] [CrossRef] [PubMed]
[32] 刘海龙, 许圆圆, 曹俊达, 等. 左西孟旦治疗心肌梗死伴心肾综合征的临床研究[J]. 药品评价, 2022, 19(2): 93-96. [Google Scholar] [CrossRef] 
[33] Lannemyr, L., Ricksten, S.E., Rundqvist, B., et al. (2018) Differential Effects of Levosimendan and Dobutamine on Glomerular Filtration Rate in Patients with Heart Failure and Renal Impairment: A Randomized Double-Blind Controlled Trial. Journal of the American Heart Association, 7, e008455. [Google Scholar] [CrossRef] 
[34] Keating, G.M. and Goa, K.L. (2003) Nesirifide: A Re-view of Its Use in Acute Decompensated Heart Failure. Drugs, 63, 47-70. [Google Scholar] [CrossRef] [PubMed]
[35] Van Deursen, V.M., Hernandez, A.F., Stebbins, A., et al. (2014) Nesiritide, Renal Function, and Associated Outcomes during Hospitalization for Acute Decompensated Heart Failure. Circulation, 130, 958-965. [Google Scholar] [CrossRef] 
[36] 王仁财. 重组人脑利钠肽(新活素)对合并肾功能不全心力衰竭病人心率变异性(HRV), 心功能, 24 h尿量, 血肌酐的影响[J]. 饮食保健, 2021, 3(3): 35.
[37] Teerlink, J.R., Cotter, G., Davison, B.A., et al. (2013) Serelaxin, Recombinant Human Relaxin-2, for Treatment of Acute Heart Failure (RELAX-AHF): A Randomised, Placebo-Controlled Trial. The Lancet, 381, 29-39. [Google Scholar] [CrossRef] 
[38] Maggioni, A.P., López Sendón, J., Nielsen, O.W., et al. (2019) Efficacy and Safety of Serelaxin When Added to Standard of Care in Patients with Acute Heart Failure: Results from a PROBE Study, RELAX-AHF-EU. European Journal of Heart Failure, 21, 322-333. [Google Scholar] [CrossRef] [PubMed]
[39] Costanzo, M.R., Negoianu, D., Jaski, B.E., et al. (2015) Aquapheresis ver-sus Intravenous Diuretics and Hospitalizations for Heart Failure. JACC: Heart Failure, 4, 95-105. [Google Scholar] [CrossRef] 
[40] Bradley, A., Bart, S.R., et al. (2012) Ultrafiltration in Decom-pensated Heart Failure with Cardiorenal Syndrome. The New England Journal of Medicine, 367, 2296-2304.
[41] 严文艳, 邬步云, 李杏, 等. 连续性肾脏替代治疗1型心肾综合征患者的预后及影响因素[J]. 肾脏病与透析肾移植杂志, 2016, 25(3): 214-219. [Google Scholar] [CrossRef] 
[42] 韦华璋, 傅帆, 鄢永安, 等. 连续性肾脏替代治疗对I型心肾综合征患者心肾功能及预后的影响[J]. 实用临床医学, 2020, 21(10): 1-4. [Google Scholar] [CrossRef] 
[43] 赵智睿, 陈岚, 陈文梅, 等. 目标导向的肾替代治疗对1型心肾综合征预后的影响[J]. 中国血液净化, 2019, 18(1): 16-20. [Google Scholar] [CrossRef] 
[44] 高青豹, 戴喜明, 陈鹏, 等. 接受CRRT的1型心肾综合征患者的预后及影响因素分析[J]. 河北医学, 2019, 25(8): 1397-1400. [Google Scholar] [CrossRef] 

为你推荐