André M, Normand J, Bozio A, Sassolas F, Jocteur-Monrozier D
Service de cardiologie pédiatrique, Hôpital Cardiologique, Lyon, France.
Pediatrie. 1992;47(1):23-9.
In recent years, thanks to a better understanding of the pathophysiology of congestive heart failure and progress made in the pharmacology of cardiovascular drugs, new therapeutics have been advocated in the treatment of congestive heart failure. Among them, converting enzyme inhibitors are the most useful. However, the classical association of digoxin-furosemide and general measures remains a very effective first-choice treatment in most cases. Only in particular situations, such as cardiomyopathy and decompensated atrio-ventricular insufficiency, should priority be given to converting enzyme inhibitors. Phosphodiesterase inhibitors are essentially used within the context of post-cardiac surgery intensive care. Beta-blockers which have been recently proposed for treatment of adult patients must not be used, as there is still no data available on their effectiveness and tolerance in pediatric patients.
近年来，由于对充血性心力衰竭病理生理学的更好理解以及心血管药物药理学取得的进展，在充血性心力衰竭的治疗中提倡采用新的治疗方法。其中，转换酶抑制剂最为有用。然而，在大多数情况下，传统的地高辛 - 呋塞米联合应用及一般措施仍是非常有效的首选治疗方法。只有在特殊情况下，如心肌病和失代偿性房室功能不全，才应优先使用转换酶抑制剂。磷酸二酯酶抑制剂主要用于心脏手术后的重症监护。最近提出用于治疗成年患者的β受体阻滞剂不得使用，因为目前尚无关于其在儿科患者中的有效性和耐受性的数据。
