Winzer E B, Schuler G C
Klinik für Innere Medizin/Kardiologie, Universität Leipzig - Herzzentrum, Strümpellstr. 39, 04289, Leipzig, Deutschland,
Herz. 2014 Jun;39(4):483-94. doi: 10.1007/s00059-014-4108-z.
In patients with coronary heart disease the further course of the disease can be substantially influenced by means of a targeted treatment of risk factors. A reduction of hospital referrals, an improvement in quality of life and an extension in life expectation by secondary prophylactic measures have been well documented. In addition to an optimized medicinal therapy, an often drastic change in lifestyle with a focus on a consistent abstinence from nicotine, a healthy diet and regular physical exercise is necessary. Data from healthcare research show that these targets are only insufficiently achieved. The implementation of current guidelines should therefore be rigorously applied. There is a need for research particularly with respect to the prognostic significance of beta blocker therapy for patients with stable coronary heart disease and preserved left ventricular function, the prognostic significance of targeted weight loss for overweight or obese coronary heart disease patients, the effectiveness of psychosocial interventions in the various patient groups and their implementation into routine care. Research is also necessary with respect to optimization of structured rehabilitation programs and improvement in patient compliance.
在冠心病患者中,通过针对性地治疗危险因素,疾病的进一步发展过程会受到显著影响。二级预防措施可减少医院转诊、改善生活质量并延长预期寿命,这一点已有充分记录。除了优化药物治疗外,生活方式通常还需要发生重大改变,重点是持续戒烟、健康饮食和定期体育锻炼。医疗保健研究数据表明,这些目标的实现程度仍显不足。因此,应严格执行现行指南。尤其需要开展研究,以明确β受体阻滞剂治疗对左心室功能正常的稳定型冠心病患者的预后意义、超重或肥胖冠心病患者针对性减重的预后意义、不同患者群体中社会心理干预的有效性及其在常规护理中的实施情况。在优化结构化康复计划和提高患者依从性方面也有必要进行研究。