2016心臟衰竭最新治療指引

10.6666/ClinMed.2017.79.6.063

江國峰；黃金隆

心臟衰竭 ； 治療指引 ； ARNI ； If -channel blocker

臨床醫學月刊

79卷6期（2017 / 06 / 30）

342 - 346

繁體中文

心臟衰竭之治療指引自2012年歐洲心臟醫學會及2013年美國心臟醫學會分別發表治療指引後，終於同時於2016年5月發表重大資料更新，給臨床醫師做為重要治療依據。其中介入兩種近年來發展用來治療心衰竭的藥物，第一種為ARNI(angiotensin receptor neprilysin inhibitor)，如安喘心(Entresto®)，是ARB加上neprilysin抑制劑兩種藥物結合，這種藥物對於心臟衰竭的病患，特別是收縮力不全的心衰竭病患，比起傳統的ACEI更能有效下降死亡率及再住院率。另一種新藥為If-channel blocker，如康立來(ivabradine) (Coralan®)，是單純的降心跳製劑，具選擇性且專一性地抑制心臟的節律If電流，可以讓心臟衰竭病患的心跳下降，因此可使得死亡率及再住院率下降。關於心衰竭的治療指引，歐洲心臟醫學會有更多的著墨，包括如何早期診斷心衰竭、避免心衰竭病患產生猝死的危險性、儀器治療的新適應症、急性心衰竭的早期治療及診斷皆有新的概念介入，相當重要！

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