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20年来,肾上腺素能β受体阻断剂(下称β阻断剂)用于心绞痛和高血压的治疗相当成功。但其在心肌梗塞治疗中的作用还未能肯定。现有可靠证据显示β阻断剂对心肌梗塞康复患者的治疗价值。 统计学分析,几乎可肯定无β阻断剂治疗禁忌症的心肌梗塞康复患者,口服β阻断剂期间病死率下降。此结论得自19篇临床实验报道(16000多例),这些患者随机接受β阻断剂或安慰剂均达3年之久。资料表明病死率下降近20％(从10.1％下降至8.0％)。关于病死率下降的机理有两种看法,一是β阻断剂可能通过防止室颤而防止猝死;二是防止了心肌梗塞复
For 20 years, the treatment of angina pectoris and hypertension has been quite successful with adrenergic beta blockers (beta blockers). But its role in the treatment of myocardial infarction has not yet been confirmed. There is reliable evidence available to show the therapeutic value of beta blockers in patients with myocardial infarction. Statistical analysis, it is almost certain that patients with congestive heart failure without beta-blocker treatment contraindications will have a lower case-fatality rate during oral beta blockers. This conclusion is drawn from 19 clinical trials (more than 16,000 cases), these patients randomized to either beta blockers or placebo for up to 3 years. Data showed a nearly 20% reduction in mortality (from 10.1% to 8.0%). On the mechanism of mortality decreased in two ways, first, β blockers may prevent sudden death by preventing ventricular fibrillation; the second is to prevent myocardial infarction complex