连续性肾脏替代治疗在心力衰竭中的应用

Application of continuous renal replacement therapy in patients with heart failure

心力衰竭(HF)是各种心脏结构或功能性疾病导致心室充盈和(或)射血功能受损,心排血量不能满足机体组织代谢需要,以肺循环和(或)体循环淤血,器官、组织血流灌注不足为临床表现的一组综合征,主要表现为呼吸困难、体力活动受限和体液潴留。目前HF的患病率和住院率呈逐年上升趋势,已成为主要的公共卫生问题之一。HF的常规治疗方法包括消除诱因、限制液体入量,强心、利尿、扩血管等药物治疗。减少体内水钠潴留,减轻心脏前负荷及调节心脏神经内分泌功能是治疗HF的重要组成部分。连续性肾脏替代治疗(CRRT)通过超滤作用清除患者体内多余的水分及调节神经内分泌功能,可有效改善患者的HF症状,目前已广泛应用于临床。本文将对CRRT在HF患者中的应用进行综述,以期更好地指导CRRT在HF患者中的应用。

Heart failure(HF)is a variety of structural or functional diseases of the heart that result in impaired ventircular filling and/or ejection.Cardiac output cannot meet the needs of tissue metabolism.Pulmonary circulation or systemic circulation congestion,organ,tissue blood insufficiency as the main clinical manifestations.The main manifestations are dyspnea,limited physical activity,and fluid retention.At present,the prevalence and hospitalization rate of HF are increasing year by year,and it has become a major public health problem.Treatment for HF includes elimination of triggers,fluid restriction,medications to strengthen the heart,diuretic,and dilate blood vessels.Reducing water and sodium retention,alleviating cardiac preload and regulating cardiac neuroendocrine function are important components in the treatment of HF.Continuous renal replacement therapy(CRRT)can effectively improve the symptoms of HF in patients by removing excess water and regulating neuroendocrine function through ultrafiltration,and has been widely used in clinical practice.This article will review the application of CRRT in HF patients,in order to better guide the application of CRRT in HF patients.