Follath F
Departement für Innere Medizin, Universitätsspital Zürich.
Ther Umsch. 1993 Jun;50(6):425-33.
The amelioration of symptoms and the improvement of long-term prognosis are the main objectives of drug treatment in congestive heart failure [CHF]. Digitalis, glycosides and diuretics can reduce dyspnea and increase exercise tolerance, while their influence on the course of the cardiac failure remains uncertain. Vasodilators, ACE inhibitors in particular, have in contrast not only the desirable symptomatic and hemodynamic effects, but they also delay the deterioration of LV dysfunction and reduce cardiac mortality. Vasodilators, therefore, became first-line drugs in all stages of CHF. In patients with moderate to severe heart failure the addition of diuretics and also of digoxin is usually required. Pharmacological effects, dosage, side effects and specific indications of the various drug groups in CHF are discussed.
缓解症状和改善长期预后是充血性心力衰竭（CHF）药物治疗的主要目标。洋地黄、糖苷类和利尿剂可减轻呼吸困难并提高运动耐量，但其对心力衰竭病程的影响仍不确定。相比之下，血管扩张剂，尤其是ACE抑制剂，不仅具有理想的症状性和血流动力学效应，还能延缓左心室功能障碍的恶化并降低心脏死亡率。因此，血管扩张剂成为CHF各阶段的一线药物。对于中重度心力衰竭患者，通常还需要加用利尿剂和地高辛。本文讨论了CHF中各类药物的药理作用、剂量、副作用及具体适应证。
