Erne P
Abteilung Kardiologie, Kantonsspital Luzern.
Praxis (Bern 1994). 1995 Feb 7;84(6):176-80.
Endothelial dysfunctions, nonocclusive coronary thrombi and plaque ruptures cause unstable angina pectoris, an instability of coronary artery disease and are accompanied by an increased risk of sudden death and acute myocardial infarction. Clinical factors, angiography and newer laboratory measurements help to identify patients who should be assigned to surgical or interventional revascularization or to medical therapy. In contrast to revascularization procedures, medical therapy is available everywhere at any time. Monotherapy either by use of betablockers or calcium antagonists can not be recommended while nitrates are a cornerstone in medical therapy for unstable angina. Nitrates in combinations with betablockers and calcium antagonists have been shown to reduce the number and duration of ischaemic episodes. These combinations also reduce the incidence of acute myocardial infarction, sudden death and the need for surgical revascularization.
内皮功能障碍、非闭塞性冠状动脉血栓形成和斑块破裂会导致不稳定型心绞痛，这是冠状动脉疾病的一种不稳定状态，并伴有猝死和急性心肌梗死风险增加。临床因素、血管造影和更新的实验室检测有助于识别应接受外科或介入性血运重建或药物治疗的患者。与血运重建手术不同，药物治疗随时随地都可进行。不推荐单独使用β受体阻滞剂或钙拮抗剂进行单药治疗，而硝酸盐类药物是不稳定型心绞痛药物治疗的基石。硝酸盐类药物与β受体阻滞剂和钙拮抗剂联合使用已被证明可减少缺血发作的次数和持续时间。这些联合用药还可降低急性心肌梗死、猝死的发生率以及外科血运重建的必要性。
