摘要
心肾综合征是指心脏或肾脏急性或慢性功能障碍而导致另一器官的急性或慢性功能损害的临床综合征.根据心肾疾病发病的相互关系将其分为五型.目前认为发病机制与肾素-血管紧张素-醛固酮系统及交感神经系统的过度激活、一氧化氮/氧自由基的失衡、贫血、炎症等相关.心肾综合征的治疗方面尚缺乏大样本临床试验资料,可选择利尿剂、血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂、β-受体阻滞剂、促红细胞生成素等,一些新型药物如选择性腺苷A1受体拮抗剂、血管加压素受体拮抗剂正进入临床,如出现药物抵抗应早期行肾脏替代治疗.
The cardiorenal syndrome （CRS） is defined as a complex pathophysiological disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other. A new classification of CRS has been proposed with five subtypes that reflect the pathophysiology, the bidirectional nature of heart and kidney interaction and the time-frame. The pathophysiology of the CRS involves interrelated hemodynamic and neurohormonal mechanisms, including the renin-angiotensin- aldosterone system, the sympathetic nervous system, the imbalance between nitric oxide and reactive oxygen species, anemia, inflammation and others such as endothelin and arginine vasopressin system activation. CRS remains a challenge in treatment options. Traditional agents, including diuretics, angiotensin converting enzyme inhibitors/angiotensin receptor blocker, 13-blockers and erythropoietin, are chosen to alleviate symptoms. Novel agents, such as adenosine A1 antagonists and vasopressin receptor antagonists, have been evaluated in randomized controlled trials. Renal replacement therapy should be used early if diuretic resistance exists.
出处
《中华老年多器官疾病杂志》
2012年第1期6-10,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
心肾综合征
发病机制
分类
治疗
cardiorenal syndrome
pathogenesis
classification
treatment
