[1]邓耀庭 卢伟杰 盛鹏程 刘梦洋 胡玉洁 杨康 欧小鹏 王博雯 谢萍.HFpEF合并CKD患者的联合管理策略[J].心血管病学进展,2025,(9):829.[doi:10.16806/j.cnki.issn.1004-3934.2025.09.014]
　DENG Yaoting,LU Weijie,SHENG Pengcheng,et al.Combined Management Strategies for Patients with HFpEF and CKD[J].Advances in Cardiovascular Diseases,2025,(9):829.[doi:10.16806/j.cnki.issn.1004-3934.2025.09.014]
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HFpEF合并CKD患者的联合管理策略()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年9期
页码:
829
栏目:
综述
出版日期:
2025-09-25

文章信息/Info

Title:
Combined Management Strategies for Patients with HFpEF and CKD
作者:
邓耀庭1 卢伟杰2 盛鹏程4 刘梦洋1 胡玉洁5 杨康1 欧小鹏1 王博雯3 谢萍3
(甘肃中医药大学第一临床医学院,甘肃 兰州 730030;2.甘肃中医药大学中西医结合学院,甘肃 兰州 730030;3.甘肃省人民医院心内科,甘肃 兰州730030;4.蚌埠医科大学,安徽 蚌埠 233000;5.兰州大学第一临床医学院,甘肃 兰州 730030)
Author(s):
DENG Yaoting1; LU Weijie2; SHENG Pengcheng3; LIU Mengyang1; HU Yujie4; YANG Kang1; OU Xiaopeng1; WANG Bowen5; XIE Ping5
(1.The First Clinical Medical College of Gansu University of Traditional Chinese Medicine,Lanzhou 730030,Gansu,China2.College of Integrated Traditional Chinese and Western Medicine,Gansu University of Traditional Chinese Medicine,Lanzhou 730030,Gansu,China; 3.Bengbu Medical University,Bengbu 233000,Anhui,China4.The First Clinical Medical College of Lanzhou University,Lanzhou 730030,Gansu,China; 5.Department of Cardiology,Gansu Provincial People’s Hospital,Lanzhou 730030,Gansu,China)
关键词:
射血分数保留的心力衰竭; 慢性肾脏病; 病理生理; 诊断; 治疗; 管理
Keywords:
Heart failure with preserved ejection fraction; Chronic kidney disease; Pathophysiology; Diagnosis; Treatment; Management
DOI:
10.16806/j.cnki.issn.1004-3934.2025.09.014
摘要:
射血分数保留的心力衰竭（HFpEF）和慢性肾脏病（CKD）是两种常见且相互影响的疾病，显著影响患者预后。全球范围内，与CKD相关的HFpEF患病率不断上升，相较于其他类型的HFpEF，其发病率和死亡率更高。流行病学数据显示，HFpEF和CKD之间存在强双向关系，二者在彼此患者群体中高发，导致心血管事件发生率和全因死亡率显著升高。病理生理机制则涉及血管功能改变、肾素-血管紧张素-醛固酮系统激活、慢性炎症及代谢紊乱，这些因素相互作用，进一步加重心肾功能损害。在诊断方面，临床评估、实验室生物标志物以及新兴工具如肺动脉搏动指数等在患者识别和风险分层中具有重要价值。在治疗方面，尽管缺乏特异性疗法，血管紧张素受体脑啡肽酶抑制剂、醛固酮拮抗剂、钠-葡萄糖共转运蛋白2抑制剂和超滤等在改善心肾结局方面显示出潜力。同时，精准医疗和联合治疗策略有望进一步优化HFpEF合并CKD患者的管理。
Abstract:
Heart failure with preserved ejection fraction(HFpEF) and chronic kidney disease(CKD) are two common and mutually influencing diseases that significantly affect patient prognosis. Globally,the prevalence of HFpEF associated with CKD is rising,and its incidence rate and mortality are higher than other types of HFpEF. Epidemiological data suggest a strong bidirectional relationship between HFpEF and CKD,with a high incidence in each other’s patient populations,leading to significant increases in cardiovascular events and all-cause mortality. The pathophysiological mechanism involves changes in vascular function,activation of renin-angiotensin-aldosterone system,chronic inflammation and metabolic disorders,and these factors interact to further ag gravate the damage of heart and kidney function. In terms of diagnosis,clinical assessments,laboratory biomarkers,and emerging tools(such as pulmonary pulse index) are of great value in patient identification and risk stratification. In terms of treatment, angiotensin receptor-neprilysin inhibitor,aldoste rone antagonist,sodium-glucose cotransporter 2 inhibitor,and ultrafiltration have shown potential in improving cardiorenal outcomes,despite the lack of specific therapies. At the same time,precision medicine and combination therapy strategies are expected to further optimize the management of patients with HFpEF and CKD

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更新日期/Last Update: 2025-12-18