Hackenbruck H A
Georgetown University, Washington, DC, USA.
Clin Excell Nurse Pract. 2000 Jul;4(4):197-204.
Congestive heart failure (CHF) is a disease with high mortality rates and increasing prevalence in the United States. As our understanding of the pathophysiologic characteristics of this disease has progressed, so has our pharmacologic approach to treatment. Digoxin was the first documented drug used in the treatment of CHF, and since that time, the efficacy of its use has been the source of great controversy. A more recent treatment option is the use of angiotensin-converting enzyme (ACE) inhibitors, the first drug class shown to increase survival rates in CHF. Although controversy remains, ACE inhibitors appear to be gaining favor over digoxin in the pharmacologic approach to treatment. This article provides a pathophysiologic review of CHF as it is understood today, the rationale behind the use of digoxin and ACE inhibitors, and a challenge for the future in the pharmacotherapy of CHF.
充血性心力衰竭（CHF）是一种在美国死亡率高且患病率不断上升的疾病。随着我们对这种疾病病理生理特征的认识不断深入，我们的药物治疗方法也在不断发展。地高辛是最早被记录用于治疗CHF的药物，自那时起，其使用效果一直存在很大争议。一种更新的治疗选择是使用血管紧张素转换酶（ACE）抑制剂，这是首个被证明可提高CHF患者生存率的药物类别。尽管争议仍然存在，但在药物治疗方法上，ACE抑制剂似乎比地高辛更受青睐。本文对当今所理解的CHF进行了病理生理综述，阐述了使用地高辛和ACE抑制剂的理论依据，并对CHF药物治疗的未来提出了挑战。
