新五联治疗射血分数降低的心力衰竭一例
摘要
症之一。近阶段，在全球范围内，关于心力衰竭治疗的研究取得了显著进展。依据最新发布的指导原则，降低慢性心功能
不全患者（HFrEF）的整体或心血管死亡风险的推荐药物包括沙库巴曲缬沙坦（ARNI）/ 血管紧张素转换酶抑制剂（ACEI）
或血管紧张素Ⅱ受体拮抗剂（ARB）、β 受体阻滞剂、醛固酮受体拮抗剂（MRA）以及 SGLT-2 抑制剂，这四种药物组
合被称为“新型四联疗法”[1]。2022 年美国心衰指南与 2023 年 ESC 心衰指南均强调，对于 NYHA 分级为Ⅱ至Ⅳ级且左室
射血分数（LVEF）不超过 45% 的患者，即便已接受标准治疗（GDMT），若近期有心力衰竭恶化的高风险，可以考虑使
用维立西呱以降低住院和心血管死亡的风险 [1]。在新指南中，维立西呱在治疗难治性心衰中的应用推荐级别有所提升，临
床使用态度更为积极。本文对一名射血分数下降的心衰患者在接受新五联疗法治疗后所取得的显著疗效进行了详尽记录。
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