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冠心病是中、老年人的常见病、多发病,为加强其防治工作,现将治疗中的一些近代认识综述如下:目前内科处理心绞痛的一些看法关于β—受体阻滞剂的应用问题:作为防治心绞痛、心肌缺血、缩小心肌梗塞范围,纠正心律失常,减少心肌耗氧量的药物中,β—受体阻滞剂是一种重要的进展,而心得安是β—受体阻滞剂的代表.它使心率减慢,血压降低,心肌收缩力减退,心排血量降低并有奎尼丁样细胞膜抑制作用.使运动时血液动力学方面的反应减低,使同一运动量水平时氧消耗量减少。不利作用包括心室射血时间延长和心脏容积增加.这些因素可能导致心脏缺血加重或引起充血性心力衰竭.但其心肌氧耗量减少因素明显超过不利因素.目前多主张硝酸甘油类药物与β受体阻滞剂联用,如消心痛加心得安等对预防频繁发生的心绞痛效果更为明显。由于心得安通过降低心肌收缩力、血压及心率的影响使心脏的氧耗量减少,结果心肌血氧的供与求得到了平衡.关于潘生丁的作用:一般认为可增加冠状动脉
Coronary heart disease is a common disease in middle and elderly people, frequently-occurring disease, in order to strengthen its prevention and treatment, now some of the treatment of modern understanding are summarized as follows: Current view of some of the medical treatment of angina on the application of β-blockers Problem: Beta-blockers are an important advancement in the prevention and treatment of angina pectoris, myocardial ischemia, narrowing the range of myocardial infarction, correcting cardiac arrhythmia and decreasing myocardial oxygen consumption, and propranolol is β-blocker Agent.It makes the heart rate slow down, blood pressure, decreased myocardial contractility, decreased cardiac output and quinidine-like cell membrane inhibit the exercise hemodynamic response to reduce the same amount of exercise level of oxygen Consumption reduced. Adverse effects, including prolonged ventricular ejection time and increased cardiac volume These factors may lead to increased myocardial ischemia or congestive heart failure, but its myocardial oxygen consumption decreased significantly more than unfavorable factors.Now many advocates nitroglycerin and β Receptor blockers combined, such as heartburn plus propranolol, etc., to prevent the frequent occurrence of angina pectoris effect is more obvious. As the peace of mind by reducing myocardial contractility, the impact of blood pressure and heart rate to reduce the oxygen consumption of the heart, the results of myocardial oxygen supply and demand has been balanced on the role of dipyridamole: generally considered to increase coronary artery