Rodgers J E, Patterson J H
Schools of Pharmacy, University of North Carolina at Chapel Hill, 27599-7360, USA.
Pharmacotherapy. 2000 Nov;20(11 Pt 2):368S-378S. doi: 10.1592/phco.20.18.368s.34606.
Numerous clinical trials have highlighted the role of the renin-angiotensin-aldosterone (RAA) system in the development and progression of heart failure. Over 30 randomized, controlled trials have evaluated the effects of angiotensin-converting enzyme (ACE) inhibitors on morbidity and mortality in over 7,000 patients with heart failure. Cumulative evidence from these trials shows that these agents significantly reduce mortality and hospitalizations, slow disease progression, and improve exercise tolerance and New York Heart Association class. The Heart Failure Society of America guidelines recommend ACE inhibitors as standard therapy for patients with left ventricular systolic dysfunction. The angiotensin receptor blockers and spironolactone offer alternative and perhaps complimentary mechanisms by which the RAA system may be therapeutically manipulated. The role of these therapies in treating heart failure is discussed.
众多临床试验突出了肾素-血管紧张素-醛固酮（RAA）系统在心力衰竭发生和发展中的作用。30多项随机对照试验评估了血管紧张素转换酶（ACE）抑制剂对7000多名心力衰竭患者发病率和死亡率的影响。这些试验的累积证据表明，这些药物可显著降低死亡率和住院率，减缓疾病进展，提高运动耐量并改善纽约心脏协会心功能分级。美国心力衰竭学会指南推荐ACE抑制剂作为左心室收缩功能障碍患者的标准治疗方法。血管紧张素受体阻滞剂和螺内酯提供了可对RAA系统进行治疗性调控的替代且可能互补的机制。本文讨论了这些疗法在治疗心力衰竭中的作用。
