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老年心力衰竭治疗的关注点

  

  1. 华中科技大学协和医院 心内科,湖北 武汉 430022
  • 出版日期:2017-03-05 发布日期:2017-03-06
  • 通讯作者: 通信作者:卢永昕,Email:yongxin_lu6@aliyun.com
  • 作者简介:卢永昕,教授,主任医师,FESC,中华医学会心血管分会心力衰竭学组委员,中国医师协会心血管分会委员,中国医师协会高血压分会委员,中国高血压联盟理事,国际高血压学会会员,欧洲心力衰竭学会会员,主要研究方向:心力衰竭,高血压,分子心脏病学。

Concerns in treatment of elderly hear failure

  1. Departmentof Cardiology, Union Hospital, Huazhong University of Science
    and Technology, Wuhan 430022, China
  • Online:2017-03-05 Published:2017-03-06
  • Contact: Correspondingauthor:Lu Yongxin,Email:yongxin_lu6@aliyun.com

摘要: 老年心力衰竭(心衰)患者存在特殊性,并发症多或多病共存,个体差异大,虚弱痴呆营养不良等错综复杂。本文介绍最新欧洲心衰指南中关于老年心衰的特殊关注点,如何判断虚弱。强调老年心衰治疗总的原则是整体评估,个体化处理。慢性心衰时常用的治疗策略对老年患者有何不同,急性心衰的治疗分为3个阶段。具体用药时关注要点。何时抗凝,抗凝药物在老年肾功能异常时剂量的调整。现有的心衰指南来自循证医学的研究,多病共存通常被排除在外,单病的指南存在局限性,应改变相应的治疗策略。

关键词: 心力衰竭, 诊断, 治疗, 老年人, 指南

Abstract: Heart failure management is complicated by aging, comorbidities, frailty and cognitive impairment, cachexia and so on. The paper focuses on specific recommmdations regarding monitoring and followup of the elderly with heart failure by 2016 ESC guidelines for diagnosis and treatment of acute and chronic heart failure. Discussion of treatment heart failure in elderly patients, evaluation of globalcondition and individual therapy are important. Introduction of thromboemolism  prophylaxia  in elderly patients with heart  failure. The current guidelines from evidence base for HF treatment is more limited as comorbidities were mostly an exclusion criterion in trials, management should change the way.

Key words: heart failure, diagnosis, treatment, aged, guidebooks