Ashrafian Houman, Violaris Andonis G
Department of Cardiology, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
Prim Care Respir J. 2005 Oct;14(5):236-41. doi: 10.1016/j.pcrj.2005.06.005. Epub 2005 Sep 2.
Extensive randomised clinical trial data support the view that beta-blockers have a significant impact on the prognosis of patients with cardiovascular disease, especially those with coronary artery disease and chronic heart failure. Unfortunately, this essential treatment is often withheld from patients with asthma and from some patients with Chronic Obstructive Pulmonary Disease (COPD). The principal concern, a concern supported by a number of guidelines, is that beta-blockers may precipitate severe and potentially fatal bronchospasm. However, a number of studies, culminating in a recent meta-analysis, show that cardioselective beta-blockers are not only safe but are beneficial in patients with co-existing airways and coronary disease. In this article we review the evidence supporting the position that cardioselective beta-blockers, when introduced with care in both community and hospital settings, are safe in patients with mild airways disease and can significantly improve prognosis.
大量随机临床试验数据支持这样一种观点，即β受体阻滞剂对心血管疾病患者的预后有重大影响，尤其是那些患有冠状动脉疾病和慢性心力衰竭的患者。不幸的是，哮喘患者以及一些慢性阻塞性肺疾病（COPD）患者往往无法接受这种重要治疗。主要担忧在于，许多指南也支持这一担忧，即β受体阻滞剂可能引发严重且可能致命的支气管痉挛。然而，一系列研究，最终以最近的一项荟萃分析为总结，表明心脏选择性β受体阻滞剂不仅安全，而且对同时患有气道疾病和冠状动脉疾病的患者有益。在本文中，我们回顾了相关证据，这些证据支持这样一种观点：在社区和医院环境中谨慎使用时，心脏选择性β受体阻滞剂对轻度气道疾病患者是安全的，并且可以显著改善预后。
