因为缺乏相关的头对头研究，心源性休克首选多巴胺还是去甲肾，一直是临床争议的焦点。究竟该如何选择？本文帮大家总结了「2 步曲」。
1明确心源性休克的分类
心源性休克（CS）的定义我们都知道，是指心脏泵血功能衰竭导致心排血量减低、血压下降，引起重要脏器和组织灌注不足、全身性微循环功能障碍。常有四肢湿冷、意识淡漠等情况。
最常见的病因包括急性冠脉综合征和慢性心力衰竭急性失代偿，少见病因有急性暴发性心肌炎、急性肺栓塞、应激性心肌病、急性感染性心内膜炎、急性心包填塞、急性主动脉疾病等。
按心源性休克潜在的血流动力学情况可大致分为 4 类。其中，以急性心肌梗死所致的湿冷型最为常见。
CI：心脏指数；SVR：体循环阻力；PCWP：肺毛细血管楔压
图片来源：作者提供
2 根据分类，选取正确治疗
2017 AHA 发布了有关《心源性休克当代管理》的科学声明，总结了各类型 CS 患者的初始治疗药物如下：
图片来源：作者提供
参考文献：
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