de Meijer P H
Department of General Internal Medicine, University Hospital, Leiden, Netherlands.
Neth J Med. 1994 Nov;45(5):225-32.
The indications for digitalis glycosides in the treatment of congestive heart failure with sinusrhythm have been disputed since early in this century. In the last decade several well designed studies have been published that have established the effectiveness of digitalis in this condition. However, new groups of drugs have been introduced in the treatment of heart failure and have been compared with digitalis. Ibopamine appeared to be an effective alternative for digitalis in patients with heart failure of low NYHA class. Because of their proven favourable effect on patient survival, ACE inhibitors are replacing digitalis as first-line drug--after diuretics--in the treatment of congestive heart failure. In this review of the literature the present place of digitalis in the treatment of heart failure is discussed.
自本世纪初以来，洋地黄苷在治疗窦性心律的充血性心力衰竭中的适应证一直存在争议。在过去十年中，已经发表了几项精心设计的研究，证实了洋地黄在这种情况下的有效性。然而，治疗心力衰竭的新药组已被引入并与洋地黄进行了比较。异波帕明似乎是纽约心脏协会心功能分级较低的心力衰竭患者中洋地黄的有效替代药物。由于血管紧张素转换酶抑制剂已被证实对患者生存有有利影响，它们正在取代洋地黄，成为继利尿剂之后治疗充血性心力衰竭的一线药物。在这篇文献综述中，讨论了洋地黄在心力衰竭治疗中的当前地位。
