在慢性心力衰竭患者中使用循环利尿剂:观察概述
Niels Tb Scholte1, Dilan Aydin1, Gerard Cm Linssen2
1Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
Open heart
|November 27, 2023
概括
循环利尿剂的使用在心力衰竭 (HF) 中很常见,特别是在减少喷射率 (EF) 的患者中. 在所有EF类型中,较高的利尿剂量与晚期HF症状,糖尿病和脏问题有关.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 循环利尿剂 (LD) 是心力衰竭 (HF) 的标准治疗方法.
- 了解整个喷射分数 (EF) 频谱的LD使用和剂量对于优化HF管理至关重要.
- 在各种高频群体中使用LD的现实数据仍然是必不可少的.
研究的目的:
- 评估循环利尿剂 (LDs) 在一大群慢性心力衰竭 (HF) 患者中的利用和剂量.
- 为了分析整个喷射分数 (EF) 频谱的LD使用和剂量.
- 为了确定与HF患者较高的LD剂量相关的临床因素.
主要方法:
- 分析了来自荷兰34家门诊的10,366名慢性HF患者.
- 每日利尿剂剂量的分层分类,以洛塞米德剂量等价剂量 (FDE) >80 mg或 ≤80 mg.
- 多变量逻辑回归以确定利尿剂剂量与临床特征之间的关联.
主要成果:
- 82.1%的HF患者使用尿剂,其中96.1%使用LDs.
- 与保存EF (73.8%) 的HF相比,LD使用率在减少EF (HFrEF) 的HF (81.1%) 中最高.
- 平均FDE为40毫克;NYHA类III-IV,糖尿病和功能障碍在所有EF类别中都与更高的FDE (>80毫克) 相关.
结论:
- 循环利尿剂的使用在慢性心力衰竭中普遍存在,特别是在HFrEF中.
- 较高的利尿剂量显着与晚期HF症状,糖尿病和功能受损有关,不论EF.
- 这些发现凸显了对HF患者量身定制的利尿剂管理策略的需要.
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