CAJ | 학술논문

目的：观察老年慢性心力衰竭伴利尿剂抵抗患者短期应用托拉塞米、呋塞米对利尿剂抵抗的临床疗效。方法：随机将60例老年慢性心力衰竭伴利尿剂抵抗患者分为呋塞米泵入组（ A组，30例）和托拉塞米静推组（ B组，30例），治疗5天，比较2组治疗前后血pro-BNP（ Pro-Brain Natriuretic Peptide ，pro-BNP）、6分钟步行试验、NYHA心功能分级、血电解质变化、尿量、肾功能等指标。结果：2组治疗后心功能均得到改善，尿量均明显增多，托拉塞米组疗效优于呋塞米组，差异有统计学意义（ P＜0．05）；托拉塞米组（B组）6分钟步行试验较呋塞米组（A组）显著增加，pro-BNP则显著降低，差异均有统计学意义（P＜0．05）；A组治疗后血钾较治疗前降低，差异有统计学意义（P＜0．05），B组血钾无明显改变（P＞0．05），2组治疗前后血钠、血肌酐均无明显变化（P＞0．05）。结论：短期泵入呋塞米和静推托拉塞米均可改善老年慢性心力衰竭伴利尿剂抵抗患者的临床症状，增加尿量，改善心功能，托拉塞米改善心功能总有效率高于呋塞米。
목적：관찰노년만성심력쇠갈반이뇨제저항환자단기응용탁랍새미、부새미대이뇨제저항적림상료효。방법：수궤장60례노년만성심력쇠갈반이뇨제저항환자분위부새미빙입조（ A조，30례）화탁랍새미정추조（ B조，30례），치료5천，비교2조치료전후혈pro-BNP（ Pro-Brain Natriuretic Peptide ，pro-BNP）、6분종보행시험、NYHA심공능분급、혈전해질변화、뇨량、신공능등지표。결과：2조치료후심공능균득도개선，뇨량균명현증다，탁랍새미조료효우우부새미조，차이유통계학의의（ P＜0．05）；탁랍새미조（B조）6분종보행시험교부새미조（A조）현저증가，pro-BNP칙현저강저，차이균유통계학의의（P＜0．05）；A조치료후혈갑교치료전강저，차이유통계학의의（P＜0．05），B조혈갑무명현개변（P＞0．05），2조치료전후혈납、혈기항균무명현변화（P＞0．05）。결론：단기빙입부새미화정추탁랍새미균가개선노년만성심력쇠갈반이뇨제저항환자적림상증상，증가뇨량，개선심공능，탁랍새미개선심공능총유효솔고우부새미。
Objective:To investigate the short-term efficacy observation on torasemide and furosemide treating diuretic resistance in elderly patients with chronic heart failure .Methods:Sixty cases with chronic heart failure with diuretic resistance were divided into two groups:pump into furosemide group(A group,n=30)and torasemide injection group (B group,n=30).Pro-Brain Natriuretic Peptide ( pro-BNP)、6 minutes walking test、heart function classification、blood electrolyte、urine output and kidney function were measured before and five days after treatment respectively .Results:By the end of five days therapy , heart function and urine output cf all patients were bet-ter than before;Heart function and urine output in torasemide injection group were significantly better compared with pump into furosemide group (P<0.05);6 minutes walking test was significantly increased in torasemide injection group compared with pump into furosemide group;pro-BNP was significantly decreased in torasemide injection group compared with pump into furosemide group (P<0.05);serum potassium was significantly decreased in pump into furosemide group compared with torasemide injection group ,no significant difference inserum sodium and serum creatinine were observed in two groups .Conclusion:Short -term pump into furosemide and torasemide injectioncan improve the clinical symptoms in elderly patients with chronic heart failure with diuretic resistance , to increase urine output and improveheart function, torasemide to improve heart failure there is always more efficient than furosemide .