CAJ | 학술논문

目的：探讨利尿剂不同时间调整剂量对腹水型晚期血吸虫病（晚血）的疗效及安全性。方法将80例腹水型晚血患者随机分为观察组和对照组，各40例。观察组患者接受螺内酯和呋塞米，首剂分别为100 mg/d和40 mg/d，若疗效不佳，按首剂量标准每4 d增量1次，逐渐增量至最大剂量螺内酯400 mg/d和呋塞米160 mg/d；对照组患者同样接受螺内酯和呋塞米，首剂与观察组相同，若疗效不佳时，则按首剂量标准每7d增量1次，逐渐增量至与观察组相同的最大剂量。其他常规治疗2组相同。结果观察组和对照组患者平均体重减轻量为（5.62±1.28）kg和（5.42±1.37）kg，平均起效时间为（3.84±2.36）d和（4.65±2.86）d，平均每日体重减轻量为（0.41±0.16）kg和（0.35±0.11）kg，有效率为95.0%和92.5%，2组差异均无统计学意义（P均＞0.05）。腹水从中度减至轻度所需时间观察组为（10.70±3.01）d，对照组为（14.75±5.62）d（u=3.876，P＜0.01）。结论采用利尿剂治疗晚血腹水，以4 d为1个周期调整剂量为宜。
목적：탐토이뇨제불동시간조정제량대복수형만기혈흡충병（만혈）적료효급안전성。방법장80례복수형만혈환자수궤분위관찰조화대조조，각40례。관찰조환자접수라내지화부새미，수제분별위100 mg/d화40 mg/d，약료효불가，안수제량표준매4 d증량1차，축점증량지최대제량라내지400 mg/d화부새미160 mg/d；대조조환자동양접수라내지화부새미，수제여관찰조상동，약료효불가시，칙안수제량표준매7d증량1차，축점증량지여관찰조상동적최대제량。기타상규치료2조상동。결과관찰조화대조조환자평균체중감경량위（5.62±1.28）kg화（5.42±1.37）kg，평균기효시간위（3.84±2.36）d화（4.65±2.86）d，평균매일체중감경량위（0.41±0.16）kg화（0.35±0.11）kg，유효솔위95.0%화92.5%，2조차이균무통계학의의（P균＞0.05）。복수종중도감지경도소수시간관찰조위（10.70±3.01）d，대조조위（14.75±5.62）d（u=3.876，P＜0.01）。결론채용이뇨제치료만혈복수，이4 d위1개주기조정제량위의。
Objective To investigate the efficacy and safety of adjusting the doses of diuretics of different time in the treat-ment of advanced schistosomiasis ascites. Methods A total of 80 advanced schistosomiasis patients with ascites were randomly divided into an observation group and a control group(40 cases each). The patients in the observation group received spironolac-tone and furosemide,and the first doses were 100 mg/d and 40 mg/d,respectively. If the efficacy was poor,according to the first doses of the standard increments once every four days,the doses gradually increased to the maximum doses of spironolactone 400 mg/d and furosemide 160 mg/d,respectively. The patients in the control group received spironolactone and furosemide,and the first doses were the same as those of the observation group. If the efficacy was poor,according to the first doses of the standard in-crements once every seven days,the doses gradually increased to the maximum doses as those of the observation group. Other con-ventional treatments were the same in both groups. Results In both groups,the reductions of the total amount of the weight were (5.62±1.28)kg and(5.42±1.37)kg respectively;the time of efficacy beginning was(3.84±2.36)days and(4.65±2.86)days re-spectively;the average daily amounts of weight loss were(0.41 ± 0.16)kg and(0.35 ± 0.11)kg respectively;the efficient rates were 95%and 92.5%respectively;and there were no significant differences between the two group(all P>0.05). However,the time of reduction from moderate ascites to mild ascites was(10.70±3.01)days(6-20 days)in the observation group and the time was(14.75±5.62)days(7-30 days)in the control group(u=3.876,P<0.01). Conclusion The therapy of diuretic doses ad-justed by a four-day cycle is more useful for advanced schistosomiasis patients with ascites.