对心力衰竭的管理. 一,药物治疗治疗方法
D W Baker1, M A Konstam, M Bottorff
1Health Sciences Program, RAND, Santa Monica, Calif.
JAMA
|November 2, 1994
概括
对所有心力衰竭患者推使用 ангиотензин转化酶 (ACE) 抑制剂. 其他药物,如利尿剂,狄戈辛,异二酸盐和氨酸,根据患者的症状和耐受性,具有特定的作用.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于左心室缩功能障碍引起的心力衰竭是一个重大的临床挑战.
- 有效的药理管理对于改善患者的治疗结果至关重要.
研究的目的:
- 总结专家小组对心力衰竭药理治疗的建议.
- 为管理心力衰竭的临床决策提供指导.
主要方法:
- 1966-1993年英语语言研究的系统审查.
- 包括大规模的前性试验以检查疗效和较小的研究以检查不良影响.
- 基于预先定义的质量标准进行随机临床试验的分析.
主要成果:
- ангиотензин转化酶 (ACE) 抑制剂是心力衰竭的第一线治疗方法.
- 利尿剂应谨慎使用,以促进ACE抑制剂定位.
- 迪戈辛仅适用于耐受性较强于ACE抑制剂和利尿剂的症状患者.
结论:
- 应给所有符合条件的心力衰竭患者服用ACE抑制剂.
- 合理使用利尿剂对于最佳的ACE抑制剂剂量至关重要.
- 替代疗法,如异索比德二酸盐/氨酸是对ACE抑制剂不耐受或耐火症状的选择.
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