血管扩张剂治疗急性心力衰竭临床研究进展

摘要

Outcomes of patients with acute heart failure (AHF) are dismal.Vasodilators are the main treatment for AHF and reduce the preload and afterload of the heart ,and alleviate symptoms .Nitrates and natriuretic are frequently administered to AHF patients that lack sufficient prognostic evidence.AHF patients could benefit from nicorandil,however requires phase Ⅲ randomized controlled trials(RCTs). While new-type vasodilators including ularitide ,serelaxin and clevidipine could improve the symptoms and outcomes of AHF patients ,they are being currently in phase ⅢRCTs.In addition,early initiation of vasodilators therapy is also beneficial to patients with AHF .This report re-views the progress in clinical evidence of vasodilators for AHF in therapy .%急性心力衰竭（ AHF）患者预后差，可减轻AHF患者心脏前后负荷并改善症状的血管扩张剂是主要治疗方法。硝酸酯和钠尿肽类药物临床应用广泛，血管紧张素转换酶抑制剂可改善预后，但研究证据不充足。尼可地尔可改善AHF患者症状和预后，但缺乏Ⅲ期临床试验。正在进行Ⅲ期临床试验的新型血管扩张剂ularitide、serelaxin及clevidipine可明显改善患者症状或预后。此外，AHF早期起始血管扩张治疗也可使患者获益。现综述血管扩张剂治疗AHF的临床研究进展。