Moser Debra K, Biddle Martha J
Department of Cardiovascular Nursing, College of Nursing, University of Kentucky, 52777 CON/HSLC Building, 760 Rose Avenue, Lexington, KY 40536-0232, USA.
Crit Care Nurs Clin North Am. 2003 Dec;15(4):423-37, vii-viii. doi: 10.1016/s0899-5885(02)00107-7.
A little more than a decade ago, management of heart failure was changed forever when a number of randomized clinical trials confirmed that a class of drugs, angiotensin-converting enzyme (ACE) inhibitors, could improve survival in patients with heart failure. The recognition that blockade of one of the neurohumoral systems activated in heart failure could improve outcomes prompted widespread testing of other neurohumoral blockers, such as beta-adrenergic blocking agents, aldosterone antagonists, and most recently, angiotensin II type 1 receptor blockers (ARBs) for the treatment of heart failure. This article describes what is known about the use of ACE inhibitors and ARBs in the management of heart failure and presents the current controversies surrounding the use of these agents.
十多年前，一些随机临床试验证实，一类药物——血管紧张素转换酶（ACE）抑制剂——能够提高心力衰竭患者的生存率，心力衰竭的治疗从此发生了永久性改变。认识到阻断心力衰竭中激活的一种神经体液系统可改善预后，促使人们广泛测试其他神经体液阻滞剂，如β-肾上腺素能阻滞剂、醛固酮拮抗剂，以及最近用于治疗心力衰竭的血管紧张素II 1型受体阻滞剂（ARB）。本文介绍了关于ACE抑制剂和ARB在心力衰竭管理中的应用的已知情况，并阐述了围绕这些药物使用的当前争议。
