β受体阻滞剂适用于所有冠心病患者吗?

Is beta blockers suitable for all patients with coronary heart disease?

既往观点认为,β受体阻滞剂(BBs)可改善冠心病患者的症状及预后,然而,越来越多的循证医学证据显示,BBs在冠心病患者治疗中的地位正在不断下降。近年来的临床研究结果显示,无心肌梗死、无心力衰竭(或射血分数减低)的冠心病患者不能从BBs治疗中获益。除合并心力衰竭外,目前无证据支持冠心病患者需终生应用BBs。增加BBs剂量并不能给冠心病患者带来额外获益。血运重建(PCI)治疗大大减少了冠心病患者对BBs的需求。本文拟对近年来BBs在冠心病治疗中的地位变迁做一综述。

It was believed that the symptoms and prognosis of patients with coronary heart disease(CHD)could be improved by beta receptor blockers(BBs).However,more and more evidence-based medical study suggests that the impact of BBs is declining in the treatment of patients with CHD.Clinical studies in recent years have shown that patients with CHD without myocardial infarction or heart failure(or cardiac dysfunction)do not benefit from BBs treatment.In addition to heart failure,there was no evidence to support the lifelong application of BBs in patients with CHD.And increasing the dose of BBs did not bring additional benefits to patients with CHD.Revascularization(PCI)treatment reduces the need for BBs in patients with CHD.In this paper,the status change of BBs in the treatment of CHD in recent years is reviewed.