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慢性缺血性心脏病的治疗选择系根据其发病的基本机理而确定。动态监测证实,以心肌需氧量增加为最主要机理的病人,对β阻滞剂的反应良好;相反,对冠状动脉痉挛病例的最佳治疗是应用钙通道阻滞剂。详细的动态监测研究显示,夜间心绞痛经常是由于心肌需氧量增加所致,用β阻滞剂治疗时,应谨慎地控制心率,以消除其内在的拟交感张力。也要考虑影响药物治疗选择的其他因素,其中吸烟尤为重要,因为它不仅对于增加心肌需氧量的一组病例具有有害的作用,而且也干扰了在肝脏内灭活的抗心绞痛制剂的代谢。最近强调了无症状性心肌缺血的重要性,通过动
The choice of treatment for chronic ischemic heart disease is based on the underlying mechanism of its onset. Dynamic monitoring confirmed that in patients with increased myocardial oxygen demand as the main mechanism of response to beta blockers; In contrast, the best treatment of coronary artery spasm cases is the application of calcium channel blockers. Detailed dynamic monitoring studies have shown that nocturnal angina is often caused by an increase in myocardial oxygen demand. With beta blockers, heart rate should be carefully controlled to eliminate its intrinsic sympathetic tone. Other factors that influence the choice of drug therapy are also considered, of which smoking is of particular importance as it not only has a deleterious effect on a group of patients with increased myocardial oxygen demand but also disrupts the metabolism of anti-anginal preparations inactivated in the liver. Recent emphasis on the importance of asymptomatic myocardial ischemia, through the move