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心肾综合征患者大量使用袢利尿剂可导致袢利尿剂抵抗,即对袢利尿剂反应性下降。其发生机制为肾脏灌注减少、肾脏结构改变、神经激素过度激活、管-球反馈反应异常、利尿后钠潴留、低蛋白血症等。袢利尿剂抵抗的处理原则是避免过度利尿,连续恒量静脉输注袢利尿剂,联用增加肾血流药物、血管紧张素转化酶抑制剂或血管紧张素受体阻断剂,积极纠正低蛋白血症,不同靶点利尿药联合使用,应用新型利尿剂,以及血液净化治疗等。
The extensive use of 袢 diuretics in patients with cardio-renal syndrome can lead to 袢 diuretic resistance, a decrease in response to 袢 diuretics. Its mechanism for the reduction of renal perfusion, renal structural changes, excessive activation of neurohormones, tube - ball feedback abnormalities, sodium retention after diuretic, hypoproteinemia.袢 diuretic resistance to deal with the principle of avoiding overdigestion, continuous constant intravenous infusion of diuretics, increased renal blood flow drugs, angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and actively correct the low protein Hyperlipidemia, different targets of diuretic drugs combined with the application of new diuretics, and blood purification treatment.