García-Palmieri M R
Department of Internal Medicine, University of Puerto Rico School of Medicine and University Hospital, San Juan 00936-5067.
Postgrad Med J. 1992;68 Suppl 1:S61-4.
A review of the available therapeutic measures for the management of stable angina pectoris is presented. The subject is critically examined by focusing on 5 main categories: general measures, drug therapy, coronary artery by-pass surgery, percutaneous transluminal coronary angioplasty and the handling of associated illnesses or disorders. General measures provide attention to the control or removal of aggravating conditions and to the institution of alterations in habits and life-style that will benefit the patient. Drug therapy depends upon the use of nitrates, beta adrenergic blockers and calcium entry blockers either alone or in combination. The mechanism of action of different drugs, its indications, as well as the dosage and frequency of use are reviewed. The indications for coronary artery by-pass surgery are presented as well as those for percutaneous transluminal angioplasty. An orientation in the selection of specific drugs when important concomitant diseases, such as hypertension and diabetes, coexist with stable angina pectoris is offered. The rationale behind the different alternatives is presented.
本文对稳定型心绞痛的现有治疗措施进行了综述。通过关注五个主要类别对该主题进行了批判性审视:一般措施、药物治疗、冠状动脉搭桥手术、经皮腔内冠状动脉成形术以及相关疾病或病症的处理。一般措施注重控制或消除加重病情的因素,并建立有利于患者的习惯和生活方式改变。药物治疗依赖于单独或联合使用硝酸盐、β肾上腺素能阻滞剂和钙通道阻滞剂。回顾了不同药物的作用机制、适应证以及使用剂量和频率。介绍了冠状动脉搭桥手术和经皮腔内血管成形术的适应证。针对稳定型心绞痛合并高血压和糖尿病等重要伴随疾病时特定药物的选择提供了指导。阐述了不同选择背后的基本原理。