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ACEI、ARB及醛固酮受体拮抗剂在心力衰竭患者中的应用
引用本文:施仲伟. ACEI、ARB及醛固酮受体拮抗剂在心力衰竭患者中的应用[J]. 心血管病学进展, 2006, 27(2): 122-125
作者姓名:施仲伟
作者单位:上海交通大学附属瑞金医院心脏科,上海,200025
摘    要:采用血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)或醛固酮受体拮抗剂,阻断或削弱肾素-血管紧张素-醛固酮系统的活性,是治疗慢性心力衰竭的主要策略之一。经过10多年的临床试验和实践,这3类药物的适应证和应用要点都已基本明确。ACEI是治疗慢性收缩性心力衰竭的基石和首选药物,ARB主要适用于不能耐受ACEI的患者。醛固酮受体拮抗剂的适应证为严重心力衰竭患者和心肌梗死后心力衰竭,使用时必须密切监测血钾和肌酐水平。

关 键 词:心力衰竭  血管紧张素转换酶抑制剂  血管紧张素受体拮抗剂  醛固酮受体拮抗剂
文章编号:1004-3934(2006)02-0122-04
收稿时间:2006-01-12
修稿时间:2006-01-12

Application of ACEI,ARB and Aldosterone Antagonists in Patients with Chronic Heart Failure
SHI Zhong-wei. Application of ACEI,ARB and Aldosterone Antagonists in Patients with Chronic Heart Failure[J]. Advances in Cardiovascular Diseases, 2006, 27(2): 122-125
Authors:SHI Zhong-wei
Affiliation:Department of Cardiology, Ruijin Hospital of Shanghai Jiaotong University, Shanghai 200025, China
Abstract:The inhibition of renin-angiotensin-aldosterone system by ACEIs, ARBs or aldosterone antagonists is one of the most important methods to treat chronic heart failure (CHF). The indications and the usage recommendations of the three kinds of drugs have been made clear by many clinical trials. ACEIs remain the first choice for inhibiting renin-angiotensin system in CHF,but ARBs can now be considered a reasonable alternative. Aldosterone antagonists are recommended in patients with advanced heart failure or with left ventricular dysfunction early after myocardial infarction. However, an increased risk of hyperkalemia was reported when spironolactone was widely used. Close monitoring of serum potassium and renal function is thus required during such a therapy.
Keywords:heart failure   angiotensin-converting enzyme inhibitor   angiotensin H receptor antagonist   aldosterone receptor antagonist
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