中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
1期
40-42
,共3页
心力衰竭%心肾综合征%托拉塞米%呋塞米
心力衰竭%心腎綜閤徵%託拉塞米%呋塞米
심력쇠갈%심신종합정%탁랍새미%부새미
Heart failure%Cadiorenal syndrome%Torasemide%Frusemide
目的 比较托拉塞米和呋塞米治疗心肾综合征的疗效及安全性.方法 60例合并肾功能不全的心力衰竭患者入院肌酐水平Ⅰ级40例、Ⅱ级20例,均完全随机平均分成托拉塞米组和呋塞米组.在常规治疗基础上,托拉塞米组加用托拉塞米20 mg/d静脉注射,呋塞米组加用呋塞米40 mg/d静脉注射.给药前后测定患者血钾、血钠、血钙、肌酐水平,记录24h尿量,同时观察患者的症状、心功能变化及不良反应发生率.结果 不同入院肌酐水平(Ⅰ级和Ⅱ级)患者托拉塞米组日平均尿量均明显高于呋塞米组[( 1685±49)rnl比(1442±38) ml,( 1042±32) ml比(968±38)ml,P＜0.05].肌酐水平Ⅰ级患者托拉塞米组心功能好转率高于呋塞米组[75％ (15/20)比65％ (13/20)],且血钾较呋塞米组明显升高[(+0.03±0.01) mmol/L比(-0.01 ±0.01)mmol/L,P＜0.05],托拉塞米组血肌酐波动范围明显较小(P＜0.05).不同肌酐水平(Ⅰ级和Ⅱ级)2组水肿消退率比较差异无统计学意义(P＞0.05),肌酐水平Ⅱ级患者心功能好转率及血钾变化2组比较差异无统计学意义(P＞0.05).托拉塞米组不良反应发生率为6.7％ (2/30),呋塞米组不良反应发生率为30.0％(9/30),2组比较差异有统计学意义(P＜0.01).结论 对心肾综合征患者,托拉塞米利尿作用及对机体内环境的稳定性明显优于呋塞米.
目的 比較託拉塞米和呋塞米治療心腎綜閤徵的療效及安全性.方法 60例閤併腎功能不全的心力衰竭患者入院肌酐水平Ⅰ級40例、Ⅱ級20例,均完全隨機平均分成託拉塞米組和呋塞米組.在常規治療基礎上,託拉塞米組加用託拉塞米20 mg/d靜脈註射,呋塞米組加用呋塞米40 mg/d靜脈註射.給藥前後測定患者血鉀、血鈉、血鈣、肌酐水平,記錄24h尿量,同時觀察患者的癥狀、心功能變化及不良反應髮生率.結果 不同入院肌酐水平(Ⅰ級和Ⅱ級)患者託拉塞米組日平均尿量均明顯高于呋塞米組[( 1685±49)rnl比(1442±38) ml,( 1042±32) ml比(968±38)ml,P＜0.05].肌酐水平Ⅰ級患者託拉塞米組心功能好轉率高于呋塞米組[75％ (15/20)比65％ (13/20)],且血鉀較呋塞米組明顯升高[(+0.03±0.01) mmol/L比(-0.01 ±0.01)mmol/L,P＜0.05],託拉塞米組血肌酐波動範圍明顯較小(P＜0.05).不同肌酐水平(Ⅰ級和Ⅱ級)2組水腫消退率比較差異無統計學意義(P＞0.05),肌酐水平Ⅱ級患者心功能好轉率及血鉀變化2組比較差異無統計學意義(P＞0.05).託拉塞米組不良反應髮生率為6.7％ (2/30),呋塞米組不良反應髮生率為30.0％(9/30),2組比較差異有統計學意義(P＜0.01).結論 對心腎綜閤徵患者,託拉塞米利尿作用及對機體內環境的穩定性明顯優于呋塞米.
목적 비교탁랍새미화부새미치료심신종합정적료효급안전성.방법 60례합병신공능불전적심력쇠갈환자입원기항수평Ⅰ급40례、Ⅱ급20례,균완전수궤평균분성탁랍새미조화부새미조.재상규치료기출상,탁랍새미조가용탁랍새미20 mg/d정맥주사,부새미조가용부새미40 mg/d정맥주사.급약전후측정환자혈갑、혈납、혈개、기항수평,기록24h뇨량,동시관찰환자적증상、심공능변화급불량반응발생솔.결과 불동입원기항수평(Ⅰ급화Ⅱ급)환자탁랍새미조일평균뇨량균명현고우부새미조[( 1685±49)rnl비(1442±38) ml,( 1042±32) ml비(968±38)ml,P＜0.05].기항수평Ⅰ급환자탁랍새미조심공능호전솔고우부새미조[75％ (15/20)비65％ (13/20)],차혈갑교부새미조명현승고[(+0.03±0.01) mmol/L비(-0.01 ±0.01)mmol/L,P＜0.05],탁랍새미조혈기항파동범위명현교소(P＜0.05).불동기항수평(Ⅰ급화Ⅱ급)2조수종소퇴솔비교차이무통계학의의(P＞0.05),기항수평Ⅱ급환자심공능호전솔급혈갑변화2조비교차이무통계학의의(P＞0.05).탁랍새미조불량반응발생솔위6.7％ (2/30),부새미조불량반응발생솔위30.0％(9/30),2조비교차이유통계학의의(P＜0.01).결론 대심신종합정환자,탁랍새미이뇨작용급대궤체내배경적은정성명현우우부새미.
Objective To observe the efficacy of torasemide and frusemide in the treatment of cadiorenal syndrome.Methods Sixty heart failure patients with renal dysfunction on admission were divided into creatinine level [ (40 cases),Ⅱ (20 cases) and were also randomly divided into torasemide group and furosemide group.Based on the conventional treatment,torasemide group were given torasemide 20 mg/d intravenously and furosemide group were given furosemide intravenous injection of 40 mg/d.Before and after the administration of drugs,the level of serum potassium,sodium,calcium,creatinine levels were determined and every 24 h urine volume were recorded.The symptoms,the changes of heart function and the incidence of adverse reactions of the two groups were observed.Results Average urine volume of different admission creatinine levels in torasemide group was significantly higher than that in the furosemide group [ ( 1685 ± 49 )ml vs (1442 ± 38 )ml,(1042 ± 32)ml vs (968 ± 38 )ml,P ＜0.05 ] ; improvement rate of heart function in torasemide group with creatinine levels stage I were higher than that in the furosemide group.The serum potassium in torasemide group increased significantly than that in furosemide group [ ( + 0.03 ± 0.01 )mmol/L vs (-0.01 ± 0.01 )mmol/L,P ＜ 0.05] with a smaller blood creatinine fluctuation range ( P ＜ 0.05 ).The swelling rate had no significant differences between the two groups ( P ＞ 0.05 ) ; cardiac function improvement rate and serum potassium changes in patients with creatinine level Ⅱ level had no significant differences between the two groups (P ＞0.05 ).The incidence of adverse reactions in the torasemide group was 6.7％ (2/30) and 30.0％ (9/30) in the furosemide group ( P ＜ 0.0l ).Conclusion In the treatment of cadiorenal syndrome,torasemide is more effective and safe than frusemide.
