- 期刊
臨床治療難題：慢性阻塞性肺病合併心臟衰竭
Coexisting Chronic Obstructive Pulmonary Disease and Heart Failure: A Therapeutic Dilemma
摘要
慢性阻塞性肺病是一個慢性呼吸道發炎所導致的氣道阻塞疾病，世界衛生組織WHO 預測2020 年慢性阻塞性肺病將成為世界第三大死因，而共病症影響慢性阻塞性肺病患者的疾病預後，而慢性阻塞性肺病的共病症當中，以心血管疾病是最主要的致死原因，儘管影響如此多的病人與無法忽視的高死亡率，如何治療同時有慢性阻塞性肺病和心臟衰竭的患者，一直都是個難解的問題。儘管心臟衰竭的治療指引建議使用乙型阻斷劑於心臟衰竭的病人，但是因為考慮到乙型阻斷劑於呼吸道的副作用，導致臨床上不敢使用乙型阻斷劑在同時有慢性阻塞性肺病和心臟衰竭患者上。而最近的研究指出對於同時有慢性阻塞性肺病和心臟衰竭患者，使用心臟選擇型的乙型交感阻斷劑可以減少死亡率，而非選擇型的乙型交感阻斷劑則無法減少死亡率。
並列摘要
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and associated with an abnormal inflammatory response in the lungs. The WHO predicts that COPD will become the third leading cause of death worldwide by 2020. Comorbidities influence the prognosis of patients with COPD among which cardiovascular disease is the major cause of depravation. Despite the large number of affected patients and greater mortality risk, the coexistence of heart failure (HF) and COPD remain a difficult condition. The practice guidelines for HF recommend the use of β-blockers, but the concern of detrimental effect of β-blockers on airway has led to suboptimal use in patients with COPD and HF. Recent studies have revealed that cardioselective β-blocker but not non-selective β-blocker increases survival in patients with coexisting HF and COPD.
延伸閱讀
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