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β肾上腺素受体阻断药被认定为心力衰竭治疗领域的里程碑,在心力衰竭指南中,β肾上腺素受体阻断药为IA类推荐。但针对慢性心力衰竭的经典、大型RCT临床试验中,房颤患者所占比率不高。新近对于心力衰竭合并房颤患者应用β肾上腺素受体阻断剂的死亡率和住院率进行Meta-分析示:β肾上腺素受体拮抗剂未见有更多临床获益(即死亡率和住院率减低水平无统计学意义)。本文就心力衰竭定义、心力衰竭时交感神经系统激活、作用于交感神经系统的β肾上腺素受体阻断药药理作用及分类、β肾上腺素受体阻断药在心力衰竭并发房颤治疗中应用地位、心力衰竭并发房颤患者应用β肾上腺素受体阻断药存在的争议及其原因分析进行简要综述。
β-adrenergic receptor blockers have been identified as milestones in the treatment of heart failure and β-adrenergic blockers are recommended for class IA in heart failure guidelines. However, in classic and large-scale RCT clinical trials of chronic heart failure, the percentage of patients with AF is low. A recent meta-analysis of the mortality and hospitalization rates of beta adrenergic blockers in patients with congestive heart failure and atrial fibrillation showed no more clinical benefit of beta adrenergic receptor antagonists (ie, mortality and hospitalization Rate of decrease was not statistically significant). In this paper, the definition of heart failure, sympathetic nervous system activation in heart failure, acting on the sympathetic nervous system β-adrenergic receptor blocker pharmacological effects and classification, β-adrenergic receptor blocker in the treatment of heart failure and atrial fibrillation Status, congestive heart failure and atrial fibrillation in patients with β-adrenergic receptor blockers exist controversy and analysis of the reasons for a brief review.