{"id":2027,"date":"2021-10-20T22:55:30","date_gmt":"2021-10-20T14:55:30","guid":{"rendered":"https:\/\/tinapoint.com\/?p=2027"},"modified":"2023-04-18T12:44:46","modified_gmt":"2023-04-18T04:44:46","slug":"g002","status":"publish","type":"post","link":"https:\/\/tinapoint.com\/g002\/","title":{"rendered":"\u3010\u6cbb\u7642\u6307\u5f15\u3011\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f15\u5927\u66f4\u65b0\uff012021 ESC \u6b50\u6d32\u5fc3\u81df\u5b78\u6703"},"content":{"rendered":"\n<p>2021\/8\/27 \u71b1\u9a30\u9a30\u7684\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f15\u4f86\u5695\uff01\u9019\u6b21ESC\u6b50\u6d32\u5fc3\u81df\u5b78\u6703\u66f4\u65b0\u4e86\u5f88\u591a\u5167\u5bb9\uff0c\u6700\u91cd\u8981\u7684\u5c31\u662f\u628aSGLT2\u6291\u5236\u5291\u7684\u89d2\u8272\u5927\u5927\u63d0\u524d\uff0c\u5c31\u8b93\u6211\u5011\u7e7c\u7e8c\u770b\u4e0b\u53bb\u5427\uff01<\/p>\n\n\n\n<!--more-->\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p><strong>\u60f3\u770b\u66f4\u591a\u5fc3\u8840\u7ba1\u75be\u75c5\u6cbb\u7642\u6307\u5f15\u55ce\uff1f\u8acb\u770b\u2192<a href=\"https:\/\/tinapoint.com\/guideline-list\/\" data-type=\"URL\" data-id=\"https:\/\/tinapoint.com\/guideline-list\/\" target=\"_blank\" rel=\"noreferrer noopener\">\u3010\u4e0d\u65b7\u66f4\u65b0\u3011\u5fc3\u8840\u7ba1\u75be\u75c5\u6cbb\u7642\u6307\u5f15\u4e00\u89bd\u8868<\/a><\/strong><\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u91cd\u9ede\u6458\u8981\"><strong>\u91cd\u9ede\u6458\u8981<\/strong><\/h2>\n\n\n\n<p>\u6b50\u6d32\u5fc3\u81df\u5b78\u6703\u4e0a\u4e00\u7248\u672c\u7684\u6cbb\u7642\u6307\u5f15\u70ba2016\u5e74\uff0c\u9019\u6b21\u66f4\u65b0\u4e86\u5f88\u591a\u5167\u5bb9\uff0c\u4e3b\u8981\u6709\u4ee5\u4e0b\u5e7e\u9ede<strong><u><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-red-color\">\u5148\u91cd\u9ede\u6458\u8981<\/mark><\/u><\/strong>\uff1a<\/p>\n\n\n\n<ol type=\"1\">\n<li>\u5fc3\u81df\u8870\u7aed\u5206\u985e\u4e2d\uff0cHFmrEF\u70ba\u5de6\u5fc3\u5ba4\u5c04\u51fa\u5206\u7387 (Left ventricule ejection fraction, LVEF) \u4ecb\u65bc41~49% \u8005\uff0c\u300cmr\u300d\u5f9e\u4e0a\u4e00\u7248\u7684\u300cmid-range\u300d\u6539\u6210\u300cmildly reduced\u300d\u3002<\/li>\n\n\n\n<li><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-red-color\"><strong>SGLT2 \u6291\u5236\u5291\u8207 ARNI \u7684\u89d2\u8272\u5347\u7d1a<\/strong><\/mark>\uff0c\u548c ACEI, Beta-blocker, MRA \u4f75\u5217\u70ba\u7b2c\u4e00\u7dda\u7528\u85e5\uff0c\u4e14\u6c92\u6709\u7cd6\u5c3f\u75c5\u7684\u5fc3\u8870\u7aed\u75c5\u4eba\u4e5f\u53ef\u4ee5\u4f7f\u7528\u3002<\/li>\n\n\n\n<li><span style=\"text-decoration: underline;\">\u6025\u6027<\/span>\u5fc3\u81df\u8870\u7aed\u7684\u5206\u985e\u5927\u5e45\u6539\u8b8a\u3002<\/li>\n\n\n\n<li>\u66f4\u65b0\u975e\u5fc3\u8840\u7ba1\u5171\u75c5\u75c7\u7684\u6cbb\u7642\u8aaa\u660e\uff0c\u5305\u62ec\u7cd6\u5c3f\u75c5\u3001\u9ad8\u8840\u9240\u3001\u9435\u8cea\u7f3a\u4e4f\u548c\u764c\u75c7\u6cbb\u7642\u3002<\/li>\n<\/ol>\n\n\n\n<p>\u8cc7\u6599\u4f86\u6e90: <a href=\"https:\/\/academic.oup.com\/eurheartj\/article\/42\/36\/3599\/6358045\" target=\"_blank\" rel=\"noreferrer noopener\">Eur Heart J.&nbsp;2021 Sep 21;42(36):3599-3726.<\/a><\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f15\u5167\u5bb9\"><strong>\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f15\u5167\u5bb9<\/strong><\/h2>\n\n\n\n<p>\u6211\u5011\u9996\u5148\u4f86\u770b\u5fc3\u81df\u8870\u7aed\u75c5\u4eba\u7684\u6cbb\u7642\u76ee\u7684\uff0c\u6709\u4e09\u500b\uff1a<\/p>\n\n\n\n<ol>\n<li>\u964d\u4f4e\u6b7b\u4ea1\u7387<\/li>\n\n\n\n<li>\u6e1b\u5c11\u5fc3\u8870\u7aed\u60e1\u5316\u518d\u4f4f\u9662\u7387<\/li>\n\n\n\n<li>\u6539\u5584\u81e8\u5e8a\u75c7\u72c0\u3001\u6d3b\u52d5\u529f\u80fd\u548c\u751f\u6d3b\u54c1\u8cea<\/li>\n<\/ol>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"961\" height=\"723\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f151.png\" alt=\"\u5fc3\u81df\u8870\u7aed\u8a3a\u65b7\u6d41\u7a0b\" class=\"wp-image-2034\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f151.png 961w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f151-300x226.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f151-768x578.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f151-585x440.png 585w\" sizes=\"(max-width: 961px) 100vw, 961px\" \/><figcaption class=\"wp-element-caption\">\u5fc3\u81df\u8870\u7aed\u8a3a\u65b7\u6d41\u7a0b<\/figcaption><\/figure>\n\n\n\n<p>2021\u5e74\u5fc3\u81df\u8870\u7aed\u7684\u5206\u985e\u9084\u662f\u4ee5LVEF\u70ba\u4e3b\uff0c\u5206\u70ba\u4e09\u7a2e\uff1a<\/p>\n\n\n\n<ul>\n<li>\u6b63\u5e38\u6536\u7e2e\u5206\u7387\u5fc3\u8870\u7aed (HFpEF)\uff0cLVEF \u226750%<\/li>\n\n\n\n<li>\u5de6\u5fc3\u5ba4\u5c04\u51fa\u5206\u7387\u8f15\u5fae\u4e0b\u964d\u5fc3\u8870\u7aed (HFmrEF)\uff0cLVEF 41~49%<\/li>\n\n\n\n<li>\u5de6\u5fc3\u5ba4\u5c04\u51fa\u5206\u7387\u4e0d\u8db3\u5fc3\u8870\u7aed (HFrEF)\uff0cLVEF \u226640%<\/li>\n<\/ul>\n\n\n\n<p>\u5206\u985e\u65b9\u5f0f\u6c92\u6709\u6539\u8b8a\uff0c\u4f46\u5c0d\u65bcHFmrEF\u7684\u300cmr\u300d\uff0c\u5f9e mid-range \u6539\u70ba mildly reduced\u3002<\/p>\n\n\n\n<p>\u4ee5\u76ee\u524d2021\u5e74ESC\u6cbb\u7642\u6307\u5f15\u5167\u5bb9\uff0c\u5c1a\u7121\u85e5\u7269\u53ef\u4ee5\u6539\u5584 HFpEF \u7684\u9810\u5f8c\uff0c\u4e3b\u8981\u4ee5\u5c0b\u627e\u75c5\u56e0\u70ba\u4e3b\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc HFmrEF \u65cf\u7fa4\uff0c\u53ef\u4ee5\u8003\u616e\u4f7f\u7528 ACEI\/ARB\/ARNI\u3001beta-blocker\u3001MRA\uff0c\u6cbb\u7642\u85e5\u7269\u6bd4\u8f03\u504f\u5411HFrEF\uff0c\u4e0d\u904e\u63a8\u85a6\u7b49\u7d1a\u4e0d\u9ad8\uff0c\u5c6c\u65bcLevel IIb\uff08\u8b49\u64da\/\u610f\u898b\u4e0d\u592a\u78ba\u5b9a\u6548\u529b\uff09\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>\u9996\u5148\u6709\u4e00\u4e9b\u7e2e\u5beb\u8b93\u5927\u5bb6\u8a8d\u8b58\u4e00\u4e0b<\/p>\n\n\n\n<ul>\n<li>ESC = European society of cardiology \u6b50\u6d32\u5fc3\u81df\u5b78\u6703<\/li>\n\n\n\n<li>HFrEF = heart failure reduced ejection fraction \u5de6\u5fc3\u5ba4\u5c04\u51fa\u5206\u7387\u4e0d\u8db3\u5fc3\u8870\u7aed<\/li>\n\n\n\n<li>HFmrEF = heart failure with mildly reduced ejection fraction<\/li>\n\n\n\n<li>HFpEF = heart failure with preserved ejection fraction<\/li>\n\n\n\n<li>LVEF = left ventricular ejection fraction<\/li>\n\n\n\n<li>ACEI = angiotensin-converting enzyme inhibitor<\/li>\n\n\n\n<li>ARNI = angiotensin receptor neprilysin inhibitor<\/li>\n\n\n\n<li>MRA = mineralocorticoid receptor antagonist<\/li>\n\n\n\n<li>SGLT2i = sodium-glucose co-transporter inhibitor<\/li>\n<\/ul>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>\u5927\u5bb6\u9084\u8a18\u5f972016\u5e74\u820a\u7248\u7684ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6d41\u7a0b\u5716\u55ce\uff1f\u7d66\u5927\u5bb6\u56de\u5473\u4e00\u4e0b\uff5e<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f152.png\" alt=\"\u820a\u72482016\u5e74ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6d41\u7a0b\u5716\" class=\"wp-image-2029\" width=\"780\" height=\"584\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f152.png 964w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f152-300x225.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f152-768x575.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f152-585x438.png 585w\" sizes=\"(max-width: 780px) 100vw, 780px\" \/><figcaption class=\"wp-element-caption\">\u820a\u72482016\u5e74ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6d41\u7a0b\u5716<\/figcaption><\/figure>\n\n\n\n<p>\u4e0a\u4e00\u7248 ESC \u6cbb\u7642\u6307\u5f15\u8a8d\u70ba\uff0cHFrEF \u75c5\u4eba\u512a\u5148\u4f7f\u7528 ACEI \u548c beta-blocker\uff0c\u82e5\u75c7\u72c0\u672a\u6539\u5584\u4e14 LVEF\u226635%\uff0c\u518d\u7d66\u4e88 MRA\u3002<\/p>\n\n\n\n<p>\u5728 ESC \u6b50\u6d32\u5fc3\u81df\u5b78\u6703\u4e0a\u4e00\u7248\u7684\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f15\uff0c\u9084\u6839\u672c\u770b\u4e0d\u5230 SGLT2i \u7684\u89d2\u8272\u3002<\/p>\n\n\n\n<p>\u81ea\u5f9e 2015 \u5e74 empagliflozin \u7684\u5927\u578b\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u986f\u793a\u53ef\u4ee5\u4e0b\u964d\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u8207\u5fc3\u81df\u8870\u7aed\u98a8\u96aa\u958b\u59cb\uff0cSGLT2i \u5c31\u50cf\u662f\u64bf\u5230\u69cd\uff0c\u4e00\u8e8d\u6210\u70ba\u5167\u5206\u6ccc\u79d1\u3001\u814e\u81df\u79d1\u548c\u5fc3\u81df\u5167\u79d1\u7684\u5bf5\u5152\uff0c\u5230\u8655\u90fd\u6709\u5ee0\u5546\u8209\u8fa6\u7684\u6f14\u8b1b\uff0c\u9080\u8acb\u5404\u79d1\u91ab\u5e2b\u4f86\u5206\u4eab\u4f7f\u7528\u7d93\u9a57\u3002\u73fe\u5728\u66f4\u662f\u6487\u9664\u964d\u8840\u7cd6\u85e5\u7269\u7684\u8eab\u5206\uff0c\u55ae\u7d14\u7528\u65bc\u5fc3\u81df\u8870\u7aed\u75c5\u4eba\u4e5f\u6709\u597d\u8655\uff0c\u8b93 SGLT2i \u5feb\u901f\u64e0\u8eab\u5230\u7b2c\u4e00\u7dda\u7528\u85e5\u7684\u884c\u5217\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"964\" height=\"722\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f153.png\" alt=\"\" class=\"wp-image-2030\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f153.png 964w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f153-300x225.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f153-768x575.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f153-585x438.png 585w\" sizes=\"(max-width: 964px) 100vw, 964px\" \/><\/figure>\n\n\n\n<p>\u8d85\u91cd\u8981\u7684\u5716\u4f86\u5566\uff01<\/p>\n\n\n\n<p>\u9019\u4e00\u7248\u672c ACEI\/ARNI\u3001beta-blocker\u3001MRA \u548c SGLT2i \u4e26\u5217\u70ba\u9996\u9078\u85e5\u7269\uff0c\u53ef\u8b02\u662f\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u7684\u56db\u5927\u5929\u738b\uff01<\/p>\n\n\n\n<p>\u4ee4\u6211\u610f\u5916\u7684\u662f\uff0cACEI\uff1dARB\u7684\u8a8d\u77e5\u4e00\u76f4\u5728\u6211\u8166\u6d77\u88e1\uff0c\u4f46\u9019\u4e00\u7248\u7684ARB\u537b\u88ab\u62c9\u5230\u5f8c\u7dda\u7528\u85e5\uff0c\u7576 ACEI\/ARNI \u7121\u6cd5\u8010\u53d7\u6642\uff0c\u624d\u8003\u616e\u4f7f\u7528\uff0c\u662f\u56e0\u70ba ARB \u4e26\u6c92\u6709\u5927\u578b\u7814\u7a76\u8b49\u5be6\u5728\u5fc3\u81df\u8870\u7aed\u7684\u597d\u8655\uff01<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"964\" height=\"722\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f154.png\" alt=\"\" class=\"wp-image-2031\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f154.png 964w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f154-300x225.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f154-768x575.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f154-585x438.png 585w\" sizes=\"(max-width: 964px) 100vw, 964px\" \/><\/figure>\n\n\n\n<p>\u9019\u6b21\u4e00\u6a23\u6709\u4e00\u5f35\u5291\u91cf\u6574\u7406\u8868\u683c\uff0c\u5927\u90e8\u5206\u85e5\u7269\u90fd\u9700\u8981\u5f9e\u8d77\u59cb\u5291\u91cf (starting dose)\u958b\u59cb\uff0c\u5728\u75c5\u4eba\u53ef\u8010\u53d7\u7684\u60c5\u5f62\u4e0b\u6162\u6162\u8abf\u6574\u5230\u76ee\u6a19\u5291\u91cf (target dose)\u3002<\/p>\n\n\n\n<p>\u4e0d\u904e SGLT2i \u662f\u552f\u4e00\u4e00\u7a2e\u300c\u958b\u59cb\u5373\u7d50\u675f\u300d\u7684\u85e5\u7269\uff0c\u5291\u91cf\u7bc4\u570d\u90fd\u662f\u4e00\u6a23\u7684\uff0c\u4e00\u5f8b\u5403 10mg qd \u5c31\u5c0d\u4e86\uff01\u4f46\u9019\u908a\u8981\u6ce8\u610f\u7684\u662f\uff0cEmpagliflozin \u5728\u5fc3\u8870\u7aed\u662f\u62ff\u5230 10mg qd \u7684\u5291\u91cf\uff0c\u548c\u6cbb\u7642\u7cd6\u5c3f\u75c5\u5e38\u7528\u7684 25mg qd \u662f\u4e0d\u540c\u7684\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"964\" height=\"723\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f155.png\" alt=\"\" class=\"wp-image-2032\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f155.png 964w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f155-300x225.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f155-768x576.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f155-585x439.png 585w\" sizes=\"(max-width: 964px) 100vw, 964px\" \/><\/figure>\n\n\n\n<p>\u63a5\u4e0b\u4f86\u8981\u6839\u64da\u75c5\u4eba\u72c0\u6cc1\u9078\u64c7\u6cbb\u7642\u65b9\u5f0f\uff0c\u6bd4\u5982\u6709\u5de6\u675f\u652f\u963b\u65b7 (Left bundle branch block, LBBB)\u7684\u60c5\u5f62\uff0c\u53ef\u4ee5\u8003\u616e\u5fc3\u81df\u518d\u540c\u6b65\u5316\u6cbb\u7642 (cardiac resynchronization therapy, CRT)\uff0c\u5fc3\u81df\u8870\u7aed\u672b\u671f\u53ef\u4ee5\u8003\u616e\u5fc3\u81df\u79fb\u690d\uff0c\u5fc3\u8df3\u901f\u7387\u8d85\u904e\u6bcf\u5206\u941870\u4e0b\u53ef\u4ee5\u8003\u616e\u52a0\u4e0aIvabradine \u2026\u2026\u7b49\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u5fc3\u81df\u8870\u7aed\u7528\u85e5\u6b65\u9a5f\"><strong>\u5fc3\u81df\u8870\u7aed\u7528\u85e5\u6b65\u9a5f<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"964\" height=\"723\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f156.png\" alt=\"\" class=\"wp-image-2033\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f156.png 964w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f156-300x225.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f156-768x576.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2021\/10\/G002-2021ESC\u5fc3\u81df\u8870\u7aed\u6cbb\u7642\u6307\u5f156-585x439.png 585w\" sizes=\"(max-width: 964px) 100vw, 964px\" \/><\/figure>\n\n\n\n<p>\u6709\u9451\u65bc\u76ee\u524d\u5177\u5f37\u529b\u5be6\u8b49\u7684\u85e5\u7269\u8d8a\u4f86\u8d8a\u591a\uff0c\u9019\u56db\u985e\u85e5\u7269\u61c9\u8a72\u6309\u7167\u4ec0\u9ebc\u6a23\u7684\u9806\u5e8f\u7528\u65bcHFrEF\u75c5\u4eba\u662f\u6700\u597d\u7684\u5462\uff1f<\/p>\n\n\n\n<p>\u904e\u53bb\u5fc3\u8870\u7aed\u7684\u6cbb\u7642\u65b9\u5f0f\uff0c\u6703\u5efa\u8b70\u5f9e ACEI\/ARB \u958b\u59cb\uff0c\u52a0\u4e0a beta-blocker \u4e26\u7528\u5230\u6700\u5927\u53ef\u8010\u53d7\u5291\u91cf\uff0c\u518d\u52a0\u4e0a MRA\uff0c\u66f4\u63db ACEI\/ARB\u70ba ARNI\uff0c\u518d\u52a0\u4e0a\u6700\u65b0\u7684 SGLT2i\uff0c\u6574\u500b\u52a0\u85e5\u6d41\u7a0b\u8d70\u5b8c\u53ef\u80fd\u90fd\u534a\u5e74\u5f8c\u4e86\uff0c\u9019\u986f\u7136\u8981\u82b1\u592a\u591a\u6642\u9593\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>\u56e0\u70ba\u5df2\u7d93\u8b49\u5be6\u9019\u5e7e\u7a2e\u85e5\u7269\u5747\u80fd\u5728\u958b\u59cb\u6cbb\u7642\u5f8c30\u5929\u5167\u964d\u4f4e\u6b7b\u4ea1\u7387\u548c\u4f75\u767c\u75c7\u767c\u751f\u7387\uff0c\u82e5\u80fd\u8b93\u85e5\u7269\u65bc4\u9031\u5167\u52a0\u4e0a\u662f\u6700\u597d\u7684\uff0c\u56e0\u6b64\u6709\u4e86\u53f3\u5716\u7684<strong><span class=\"has-inline-color has-vivid-red-color\">\u4e09\u6b65\u8d70\u6cbb\u7642\u6d41\u7a0b<\/span><\/strong>\u767c\u60f3\uff1a<\/p>\n\n\n\n<p><strong>\u7b2c\u4e00\u6b65\uff1a<\/strong>\u540c\u6642\u52a0\u4e0a beta-blocker \u548c SGLT2i\u3002<\/p>\n\n\n\n<p>beta-blocker \u662f\u6700\u6709\u6548\u7684 HFrEF \u6cbb\u7642\u85e5\u7269\u4e4b\u4e00\uff0c\u5c24\u5176\u662f\u5728\u6e1b\u5c11\u731d\u6b7b\u65b9\u9762\uff0c\u800c SGLT2i \u53ef\u4ee5\u964d\u4f4e\u5fc3\u8870\u4f4f\u9662\u98a8\u96aa\uff0c\u4e26\u4e14\u6709\u5229\u5c3f\u6548\u679c\uff0c\u53ef\u4ee5\u6e1b\u8f15\u525b\u958b\u59cb\u4f7f\u7528 beta-blocker \u53ef\u80fd\u767c\u751f\u7684\u5fc3\u8870\u60e1\u5316\u98a8\u96aa\u3002<\/p>\n\n\n\n<p><strong>\u7b2c\u4e8c\u6b65\uff1a<\/strong>1~2\u9031\u5f8c\u52a0\u4e0a ARNI\u3002<\/p>\n\n\n\n<p>\u4f46\u82e5\u6536\u7e2e\u58d3\u4f4e\u65bc100mmHg\u8981\u8b39\u614e\u8a55\u4f30\uff0c\u53ef\u80fd\u5148\u52a0\u4e0a ARB \u518d\u8abf\u6574\u70ba ARNI\uff0c\u6216\u662f\u4f4e\u8840\u58d3\u75c5\u4eba\u8df3\u904e\u7b2c\u4e8c\u6b65\uff0c\u76f4\u63a5\u52a0\u4e0a MRA \u85e5\u7269\u3002<\/p>\n\n\n\n<p><strong>\u7b2c\u4e09\u6b65\uff1a<\/strong>1~2\u9031\u5f8c\u82e5\u814e\u529f\u80fd\u548c\u8840\u9240\u72c0\u6cc1\u826f\u597d\uff0c\u53ef\u4ee5\u52a0\u4e0a MRA \u4f7f\u7528\u3002<\/p>\n\n\n\n<p>\u4e14\u7d93\u904e SGLT2i \u548c ARNI \u5c0d\u814e\u529f\u80fd\u7684\u4fdd\u8b77\u6548\u679c\uff0c\u53ef\u80fd\u6703\u589e\u52a0 MRA \u7528\u85e5\u7684\u8010\u53d7\u6027\u3002<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>\u5728\u9069\u7576\u7684\u60a3\u8005\u4e2d\u4f7f\u7528\uff0c\u4e0a\u8ff0\u65b9\u6cd5\u53ef\u4ee5\u5728 4 \u9031\u5167\u52a0\u4e0a\u56db\u985e\u85e5\u7269\uff0c\u6b64\u5f8c\u518d\u7e7c\u7e8c\u5c07\u85e5\u7269\u8abf\u6574\u81f3\u76ee\u6a19\u5291\u91cf\u3002<\/p>\n\n\n\n<p>\u4e0d\u904e\u4ee5\u4e0a\u5efa\u8b70\u4f86\u81ea\u65bc\u5169\u4f4d SGLT2i \u5927\u578b\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u7684\u4e3b\u6301\u4eba\uff0c\u4e5f\u5c31\u662f\u5c08\u5bb6\u610f\u898b\u7b49\u7d1a\u3002<\/p>\n\n\n\n<p>\u672a\u4f86\u6cbb\u7642\u6307\u5f15\u6703\u4e0d\u6703\u63a1\u7528\uff0c\u5c31\u8b93\u6211\u5011\u7e7c\u7e8c\u770b\uff5e\u4e0b~\u53bb\u5427\uff01<\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p><strong>\u60f3\u770b\u66f4\u591a\u5fc3\u8840\u7ba1\u75be\u75c5\u6cbb\u7642\u6307\u5f15\u55ce\uff1f\u8acb\u770b\u2192<a href=\"https:\/\/tinapoint.com\/guideline-list\/\" data-type=\"URL\" data-id=\"https:\/\/tinapoint.com\/guideline-list\/\" target=\"_blank\" rel=\"noreferrer noopener\">\u3010\u4e0d\u65b7\u66f4\u65b0\u3011\u5fc3\u8840\u7ba1\u75be\u75c5\u6cbb\u7642\u6307\u5f15\u4e00\u89bd\u8868<\/a><\/strong><\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-group box\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p>\u4f60\u662f\u91ab\u9662\u85e5\u5e2b\u6216\u8b77\u7406\u5e2b\u55ce\uff1f<\/p>\n\n\n\n<p>\u6642\u5e38\u9047\u5230\u75c5\u4eba\u8981\u7d66\u8a31\u591a\u91dd\u5291\u85e5\u54c1\uff0c\u7919\u65bc\u7ba1\u8def\u4e0d\u5920\u9700\u8981\u540c\u6642\u7d66\u85e5 &#8230;&#8230;<\/p>\n\n\n\n<p>\u537b\u4e0d\u77e5\u9053\u9019\u4e9b\u85e5\u7269\u53ef\u4e0d\u53ef\u4ee5\u65c1\u63d2\u4f7f\u7528\u55ce\uff1f<\/p>\n\n\n\n<p>\u5225\u64d4\u5fc3\uff01<\/p>\n\n\n\n<p>\u5c0f\u6db5\u85e5\u5e2b\u6574\u7406\u4e86\u4f4f\u9662\u75c5\u4eba\u5e38\u7528\u7684\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\uff0c\u6b61\u8fce\u9ede\u64ca\u4e0b\u5716\u7d22\u53d6\u5594\uff01<\/p>\n<\/div><\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/subscribepage.io\/EPTKCz\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" width=\"1024\" height=\"574\" src=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716-1024x574.png\" alt=\"\" class=\"wp-image-3721\" srcset=\"https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716-1024x574.png 1024w, https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716-300x168.png 300w, https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716-768x431.png 768w, https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716-585x328.png 585w, https:\/\/tinapoint.com\/wp-content\/uploads\/2023\/04\/\u91dd\u5291\u76f8\u5bb9\u6027\u901f\u67e5\u8868\u5927\u5716.png 1038w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" 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