心力衰竭中利尿剂抵抗机制研究新进展

Revealing novel insights into the mechanism of diuretic resistance in heart failure

利尿剂是急性心力衰竭(心衰)的一线治疗药物,也是临床上缓解充血症状的基石。利尿剂抵抗致使心衰患者的再入院率和病死率增加,是临床治疗的一大难点,其机制目前尚不明确。最新研究机制包括腹内高压、盆腔化学感受器等,针对这些机制已有相应的治疗手段,所涉及的有机阴离子转运多肽2B1、肾脏钠再摄取转运体基因变异机制也将大大开拓利尿剂抵抗治疗的新思路。本文将对可能产生利尿剂抵抗的机制进行梳理以及对利尿剂抵抗的新治疗手段进行概括,以期全面了解利尿剂抵抗。

Diuretics are the first-line treatment for acute heart failure and are essential for providing relief from congestion symptoms.However, with advancements in heart failure diagnosis and treatment, diuretic resistance has emerged as a significant issue.This resistance can lead to increased rates of hospital readmission and mortality among heart failure patients.The exact mechanism of diuretic resistance is still unclear, posing a challenge in clinical treatment.Recent research has explored potential mechanisms such as intra-abdominal hypertension and pelvic chemoreceptors, leading to the development of corresponding treatment approaches.Additionally, mutations in genes related to organic anion transport polypeptide 2B1 and renal sodium reuptake may provide new avenues for treating diuretic resistance.This article aims to categorize the various mechanisms of diuretic resistance and briefly summarize new treatments for diuretic resistance, enhancing our overall understanding of diuretic resistance.