治療冠心病這6類藥很重要

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各位朋友：

大家好，現在是“每天健康三分鐘”時間，我是道簡-心血管康復醫生集團的醫生卜穎穎，今天我來給大家講講：治療冠心病這6類藥很重要！

對於冠心病、心肌梗死這類病變來說，在急性發作的時候需要迅速通過溶栓或者介入治療開通堵塞的血管，挽救生命，這是毋庸置疑的。但是更重要的是平時堅持藥物治療，因為無論是否有放支架，藥物治療都是基礎，沒有規範的藥物治療，其他的血管也很可能會逐漸狹窄，堵塞。那麼冠心病最常用的藥物是哪些呢？

1、阿司匹林：對於冠心病患者來說，如果沒有禁忌症，都需要長期服用，主要作用是抗血小板凝聚，預防血栓形成。

2、他汀類藥物：例如阿託伐他汀、瑞舒伐他汀等，可以控制低密度脂蛋白膽固醇（LDL-C）、膽固醇等血脂水平，能穩定斑塊，預防斑塊破裂血栓形成。

3、β受體阻滯劑：例如美託洛爾、比索洛爾等，可以減少心肌的耗氧量，減慢心率，控制血壓，減少心絞痛發作，改善心功能，增加運動耐量。研究顯示，心梗患者長期使用後死亡率下降24%，如果沒有禁忌的話，建議可以使用。

4、普利類或者沙坦類：研究顯示，這類藥物可以使心血管死亡、心肌梗死、腦卒中的風險下降22%，可以保護心功能、抑制心室的重構，是合併心力衰竭患者治療的基石。

5、硝酸酯類藥物：例如硝酸甘油、消心痛等，屬於內皮依賴性血管擴張劑，可以改善心肌供血，緩解心絞痛的症狀，少數患者可能會出現頭痛、面部潮紅等不良反應。

6、氯吡格雷或替格瑞洛：如果阿司匹林不能耐受或有禁忌症，可以替代。如果有急性冠脈綜合症，需要和阿司匹林聯用，如果有植入藥物支架，一般至少要聯合服藥一年，然後根據情況選擇是單用阿司匹林，還是繼續雙聯抗血小板治療。

7、其他：當然根據不同的病情，我們還可以選用曲美他嗪、尼可地爾、伊伐佈雷定等等藥物。

具體需要用哪些藥物，必須在醫生指導下進行調整，切勿自行停藥。

最後，祝大家生活愉快，身體健康！如果您想要了解更多的心血管科普小知識，請關注我們，咱們下期再見。

【英文版】

Six kinds of very important drugs for the treatment of coronary heart disease

Dear friends, nice to meet you!Now it is time for “health talk for three minutes every day”,My name is Bu Yingying, a doctor of Daojian Doctor Group of Cardiovascular Rehabilitation.Today, I'd like to tell you the six important drugs for the treatment of coronary heart disease!

For coronary heart disease, myocardial infarction and other diseases,it is no doubt that thrombolytic therapy or interventional therapy is needed to open up the blocked blood vessels and save lives. However, it is more important for patients to adhere to drug treatment at ordinary times, because no matter whether there is stent implantation, drug treatment is the basis. Without standardized drug treatment, other blood vessels are likely to gradually narrow and block. So what are the most commonly used drugs for coronary heart disease?

1. Aspirin.

For patients with coronary heart disease, if there is no contraindication, patients need to take aspirin for a long term, and the main role of aspirin is to prevent platelet aggregation and thrombosis.

2. Statins.

For example, atorvastatin and rosuvastatin can control the levels of low-density lipoprotein cholesterol (LDL-C) and cholesterol, stabilize plaque and prevent plaque rupture and thrombosis.

3. Beta blockers.

Beta blocker, such as metoprolol, bisoprolol, etc., can reduce myocardial oxygen consumption, slow heart rate, control blood pressure, reduce angina pectoris attack,improve cardiac function, and increase exercise tolerance. Studies have shown that the mortality rate of patients with myocardial infarction after long-term use could be reduced by 24%. If there is no contraindication, it can be used.

4. Puli or sartans.

Studies have shown that such drugs can reduce the risk of cardiovascular death, myocardial infarction and stroke by 22%, they can also protect heart function and inhibit ventricular remodeling,which is the cornerstone of treatment for patients with heart failure.

5. Nitrates.

For example, nitroglycerin and isosorbide dinitrate are endothelium-dependent vasodilators, which can improve myocardial blood supply and relieve the symptoms of angina pectoris. A few patients may suffer from adverse reactions such as headache and flushing on the face.

6. Clopidogrel or ticagrelor.

If aspirin is intolerable or contraindicated, it can be replaced. If the patient is diagnosed with acute coronary syndrome, aspirin plus clopidogrel or ticagrelor is required.If patients have received coronary stent implantation, they usually need at least one year of combined medication, and then choose whether to use aspirin alone or continue dual antiplatelet therapy according to the situation.

7. Other drugs.

Of course, according to different conditions, we can also choose trimetazidine, nicorandil, ivabradine and other drugs.The specific drugs that patients need to take must be adjusted under the guidance of doctors, and do not stop taking drugs by themselves.

Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.