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心血管疾患和肺部疾患是目前工业发达国家中的两种常见疾患,这两种疾病通常并存。50岁以上患有慢性阻塞性肺疾病(COPD)的病人大多数合并有冠状动脉硬化性心脏病。如何综合治疗心肺疾患并存的人,这是一个棘手的问题。由于心肺疾患的治疗中存在着治疗矛盾,如合并心脏疾患的哮喘和COPD病人在使用支气管扩张剂时,易引起严重的心律失常及高血压;而对合并哮喘和COPD的心脏病人使用β-受体阻滞剂时,又容易诱发支气管痉挛。因此如何安全正确地治疗,并避免治疗矛盾的产生是个值得探讨的问题,本文从两个方面进行论述。【合并有心脏疾患的哮喘和慢性阻塞性肺疾患病人的治疗】现将支气管扩张剂及其对心血管系统的影响简述如下: 茶碱类茶碱类药物的支气管扩张作用主要通过以下3个环节:①抑制细胞内磷酸二酯酶,使cAMP分解减少;②改变细胞内外钙离子浓度,使cAMP增加;③激活酪氨酸羟化酶,促进肾上腺體质及其它嗜铬组织释放儿茶酚胺等。茶碱类还可改变膈肌的收缩力并增加其耐力时
Cardiovascular diseases and lung diseases are two common diseases in industrialized countries, and the two diseases usually co-exist. Most patients over 50 years old with COPD have coronary heart disease. How to comprehensively treat people with cardiorespiratory disorders is a thorny issue. As the treatment of cardiopulmonary disorders exist in the treatment of contradictions, such as heart disease with asthma and COPD patients in the use of bronchodilators, can lead to serious arrhythmia and hypertension; and combined with asthma and COPD in the heart of patients with beta Body blockers, but also easy to induce bronchospasm. So how to treat safely and correctly and avoid the contradictory of treatment is a question that worth exploring, this article discusses from two aspects. The treatment of patients with heart disease and chronic obstructive pulmonary disease Bronchodilators and their effects on the cardiovascular system are summarized below: The theophylline theophylline bronchodilator mainly through the following three Links: ① inhibition of intracellular phosphodiesterase, cAMP decomposition reduced; ② changes in intracellular and extracellular calcium concentration, cAMP increased; ③ activation of tyrosine hydroxylase to promote adrenal gland mass and other chromaffin tissue release of catecholamines. Theophylline can also change the contractility of the diaphragm and increase its endurance