乙型激动剂治疗慢性阻塞性气道疾病并发心房颤动患者的作用

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摘要

背景:医学已经取得了新的进展,但慢性阻塞性肺疾病(COPD)的发病率和患病率是显而易见的,并且它被确定为美国第四大死亡原因,代表了医疗保健系统的高成本。由于肺和脉管系统的改变,这种情况与心房颤动有关。基于这一历史,我们试图评估慢性阻塞性肺病患者房颤的结局及其与用于治疗这种肺部疾病的药物治疗的关系,目的是建立心房颤动患者使用-激动剂治疗阻塞性气道疾病之间的关系。细胞受体参与多种反应,交感反应通过α受体和β受体接受,与肺和心血管系统的血管动力学有关。-阻滞剂是心律失常中最常用的药物之一,但其副作用可能是慢性阻塞性肺病加重;另一方面,β -肾上腺素能或β -激动剂作为治疗这种肺部疾病可能会增加心率,导致心房颤动失代偿。对于同时患有气道疾病和房颤的患者来说,有一个明显的困境,因为治疗其中一个可能会使另一个恶化。β受体阻滞剂治疗在发病率和死亡率方面的明显优势,尤其是β受体阻滞剂选择性治疗,超过了与COPD或气道疾病加重有关的任何肺部副作用的可能性。结论:有明确的数据显示,COPD和AF治疗之间存在潜在的矛盾副作用,考虑到其中一种治疗会因另一种治疗而加重,应讨论获益与风险,并根据它们做出医疗决定。恶化的心脏状况会迅速导致导致死亡的严重并发症,这就是为什么要选择β -阻滞剂而不是肺部疾病的可能并发症。换句话说,基于对患者的最佳结果,收益应该大于风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation
Background: New advances have been made in medicine, but the incidence and prevalence of chronic obstructive pulmonary disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and betareceptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1- selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient.
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