Im Hof V I
Departement Medizin, Universitätsklinik Bern.
Praxis (Bern 1994). 1995 Mar 14;84(11):319-20.
Worsening or precipitation of asthma by beta-adrenoceptor antagonists is well recognized. Severe bronchoconstriction may be induced even in 'mild' asthmatics, and the dose of beta blocker required may be low, as in the case of eye drops of timolol, a nonselective beta blocker used to treat glaucoma. The severity of bronchoconstrictor response is not predictable. Nonselective beta blockers are more likely to precipitate bronchospasms in patients with asthma. The mechanism of beta-blocker-induced asthma is still not certain. Normal subjects develop neither a deterioration in lung function nor an increased bronchial hyperreactivity; therefore, beta blocker drugs should in general be avoided by asthma patients. Safe alternative therapies exist for both hypertension (calcium antagonists, ACE inhibitors, diuretics) and ischemic heart disease (calcium antagonists, nitrates).
β-肾上腺素受体拮抗剂可使哮喘病情恶化或诱发哮喘，这一点已得到广泛认可。即使是“轻度”哮喘患者也可能诱发严重的支气管收缩，而且诱发哮喘所需的β受体阻滞剂剂量可能很低，如用于治疗青光眼的非选择性β受体阻滞剂噻吗洛尔滴眼液的情况。支气管收缩反应的严重程度无法预测。非选择性β受体阻滞剂更易在哮喘患者中诱发支气管痉挛。β受体阻滞剂诱发哮喘的机制尚不确定。正常受试者的肺功能不会恶化，支气管高反应性也不会增加；因此，哮喘患者一般应避免使用β受体阻滞剂药物。对于高血压（钙拮抗剂、血管紧张素转换酶抑制剂、利尿剂）和缺血性心脏病（钙拮抗剂、硝酸盐），都有安全的替代疗法。
