内比洛尔作为具有血管舒张特性的β受体阻滞剂:成就和前景

G. Solovyan, Т. V. Міkhalieva, L. O. Androsova
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摘要

一篇文献综述涉及尼比沃作为具有血管舒张特性的β受体阻滞剂(BB)的临床应用。介绍了该药的主要药理学性质和特点、心脏选择性和血管舒张机制。概述了奈比洛尔在治疗原发性动脉性高血压(AH)、冠心病(CHD)和心力衰竭(HF)中的特殊地位。该药物长期使用不具有致糖尿病活性,对脂质和碳水化合物代谢参数有有利影响。在冠心病患者中,奈比洛尔表现出抗心绞痛和抗缺血的活性,降低冠状动脉介入治疗后心绞痛复发的频率。该药耐受性良好,在降低70岁以上慢性心衰患者的死亡率方面具有很高的疗效,无论左心室射血分数如何。血管扩张性BB是治疗冠心病合并2型糖尿病患者的首选药物。在非阻塞性冠状动脉病变的情况下,在现有的BBs中选择奈比洛尔治疗微血管心绞痛。在AH患者中使用奈比洛尔,除了降压作用外,其特点是对内皮功能、代谢特征、中心血流动力学、患者健康相关生活质量产生有利影响,以及更有利的副作用
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Nebivolol as a beta-blocker with vasodilating properties: achievements and prospects
A literature review deals with the clinical use of nebivol as a beta-blocker (BB) with vasodilating properties. The principal pharmacological properties and characteristics of the drug, its cardioselectivity and mechanisms of vasodilation are presented. The special place of nebivolol in the treatment of essential arterial hypertension (AH), coronary heart disease (CHD) and heart failure (HF) is outlined. The drug does not possess a diabetogenic activity with a long-term use, and impacts favourably on the parameters of lipid and carbohydrate metabolism. In CHD patients, nebivolol demonstrates the antianginal and antiischemic activities, and reduces the frequency of angina recurrence after coronary artery interventions. The drug is well tolerated and characterized by a high effectiveness with respect to the reduction of mortality rates in patients with chronic HF over 70 years of age, regardless of the left ventricular ejection fraction. Vasodilating BB are preferred in the treatment of CHD patients with type 2 diabetes. In case of non-obstructive coronary lesions, nebivolol is chosen among existing BBs for the treatment of microvascular angina. The use of nebivolol in AH patients, in addition to the antihypertensive effect, is characterized by a favorable impact on the function of endothelium, the metabolic profile, central hemodynamics, health-related quality of life of patients, as well as more favorable profile of side effects
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