慢性心衰治疗药物应用超过“临界点”易引发严重不良反应(二)

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近年来,循证医学确定了β受体阻滞剂(β阻滞剂)对心衰的治疗价值。β阻滞剂不仅能延缓和逆转心功能不全及心衰的进展,而且可降低心衰患者猝死率。根据分析,应用ACEI可使心衰患者死亡危险性下降24%,加用β阻滞剂则可使死亡危险性下降36%。因此,收缩性心衰患者除非存在对β阻滞剂的绝对禁忌症(如支气管哮喘),否则均应服用β阻滞剂。但是当前临床对心衰患者使用阻滞剂不够普遍,主要原因之一是临床医生对β阻滞剂治疗心衰的不良反应存在顾忌。β阻滞剂治疗心衰的主要不良反应为心衰暂时恶化、低血压、心动过缓。 In recent years, evidence-based medicine has determined the therapeutic value of beta blockers (beta blockers) on heart failure. Beta blockers can not only delay and reverse the progression of heart failure and heart failure, but also reduce the rate of sudden death in patients with heart failure. According to the analysis, the application of ACEI can reduce the risk of death in patients with heart failure by 24%, plus beta blockers can reduce the risk of death by 36%. Therefore, patients with systolic heart failure should take beta blockers unless there is an absolute contraindication to beta blockers, such as bronchial asthma. However, the current clinical use of blockers in patients with heart failure is not common enough, one of the main reasons clinicians treat β-blockers adverse effects of heart failure with scruples. The main adverse effects of beta blockers in the treatment of heart failure are temporary worsening of heart failure, hypotension and bradycardia.
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