充血性心力衰竭时低钠血症治疗的进展

Current Treatments for Hyponatremia in Congestive Heart Failure

低钠血症是充血性心力衰竭的严重表现,通过限制水摄入,补充钠盐和利尿等常规治疗效果不理想。精氨酸血管加压素受体拮抗剂,是一种排水利尿剂,能促进肾集合管自由水的排泄,同时能维持血循环中钠和其它电解质浓度,对充血性心力衰竭的治疗有效。精氨酸血管加压素受体拮抗剂与血管紧张素转换酶抑制剂联合应用,能进一步使血管扩张,减少容量超负荷和纠正低钠血症,改善心功能。

Hyponatremia is a serious manifestation in congestive heart failure. Current options such as fluid restriction,administration of hypertension saline solution,and diuretic therapy have limited therapeutic effect. Arginine vasopressin receptor antagonists act as a aquaresis diuretic, and can increase free-water excretion in the renal collecting ducts and maintain blood volume sodium and the other electrolyte concentrations. It offers a clinical advantage in the treatment of hyponatremia. Combination therapy with vasopressin antagonists and ACE inhibitors can be an effective approach to managing vasoconstriction, volume overload and hyponatremia, and can thus improve heart function.