心力衰竭治疗近况课件.ppt

心力衰竭治疗近况;国人不同性别、年龄组成人的心衰患病率(%);国人心衰病因;;Why?---心衰新概念;心衰新概念;心力衰竭药物治疗历史;心力衰竭的现代药物治疗;ACE抑制剂;SOLVD（Studies Of Left Ventricular Dysfunction）结果;ACE抑制剂;为什么医生不按实证医学使用ACEI？;ACEI使用要点;ACEI使用要点;常用ACEI的参考目标剂量;ARB与ACEI比较的优点;ARB的临床应用建议;利尿剂;利尿剂的应用要点（1）;利尿剂的应用要点（2）;利尿剂的应用要点（3）;?－受体阻滞剂;卡维地洛对重度慢性心衰存活率的影响Effect of Carvedilol on Survival in Severe Chronic Heart Failure;存活率 Kaplan–Meier Analysis of Time to Death in the Placebo Group and the Carvedilol Group. The 35% lower risk in the carvedilol group was significant: P=0.00013 (unadjusted) and P=0.0014 (adjusted).;总死亡和首次住院率Kaplan–Meier Analysis of Time to Death or First Hospitalization for Any Reason in the Placebo Group and the Carvedilol Group. The 24% lower risk in the carvedilol group was significant (P0.001).;撤药率Kaplan–Meier Analysis of the Time to Permanent Withdrawal of the Study Medication because of Adverse Reactions or for Reasons Other Than Death in the Placebo Group and the Carvedilol Group.;结论;?-受体阻滞剂的使用要点;?-受体阻滞剂的使用要点;?-受体阻滞剂治疗时应监测;地高辛;The Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure;; Digoxin 和 Placebo 组总死亡率：地高辛不降低总死亡率;心衰恶化死亡率 Mortality Due to Worsening Heart Failure in the Digoxin and Placebo Groups.;因心衰恶化而死亡或住院：地高辛降低因心衰恶化住院率 Incidence of Death or Hospitalization Due to Worsening Heart Failure in the Digoxin and Placebo Groups.;地高辛的长期作用;地高辛应用要点;醛固酮受体阻断剂：Spironolactone;The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure;;存活率：Spironolactone group vs placebo group: The risk of death was 30% lower (P0.001).;Relative Risks of Death from All Causes and According to Demographic and Clinical Characteristics.The horizontal lines indicate 95 percent confidence intervals. ;结论;螺内酯应用要点;机制;非洋地黄强心剂;维司力农治疗重度心衰：死亡率呈剂量依赖性增加A Dose-Dependent Increase in Mortality with Vesnarinone among Patients with Severe Heart Failure;维司力农治疗重度心衰：死亡率呈剂量依赖性增加;安慰剂、维司力农存活率比较; Subgroup Analysis of Hazard Ratios and 95 Percent Confidence Intervals for Death from Any Cause among Patie