心肾综合征的研究进展

Research progress in cardiorenal syndrome

近年来心肾疾病之间的关系已被广泛关注,随着心肾综合征(CRS)概念的提出,临床上进一步将其分为5个亚型,各亚型有不同的流行病学特点。近年多项研究认为,CRS的病理生理机制涉及中心静脉充血、神经激素作用、贫血、氧化应激和肾交感神经兴奋等;CRS的发生会伴有不同的生物学标记物的相应改变,对其早期诊断、危险评估、判断预后有重要意义;该病的治疗目前较公认的方法有血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB)、连续性肾脏替代治疗(CRRT)、重组人促红细胞生成素(rh-EPO)、奈西立肽及依普利酮等。

Objective The relationship between renal and cardiac diseases has been widely recognized in recent years.With the concept of cardiorenal syndrome（CRS）being widely applied,it has been clinically further divided into five subtypes showing different epidemiological characteristics.Recently a number of studies suggest that the pathophysiological mechanism of CRS involved the central venous congestion,neurohormonal effects,anemia,oxidative stress,and renal sympathetic nerve excitation,etc.CRS occurred with various corresponding changes of biological markers which is important for early diagnosis,risk evaluation,and prognosis judgment.The accepted treatment of CRS now includes angiotensin converting enzyme inhibitors （ACEI）,angiotensinⅡreceptor antagonist （ARB）,continuous renal replacement therapy （CRRT）,recombinant human erythropoietin （rh-EPO）,nesiritide,and eplerenone,etc.